HSLDA CANADA MEMBERSHIP RENEWAL 

To renew now, please fill out the online form below. 
HSLDA Canada will treat this information with absolute confidentiality.
If you need help filling out this form, please contact our office at 519.913.0318 for assistance.

Important note: ** if your current HSLDA Membership Type is Monthly or if you have chosen the annual auto-renew option,  and wish to update payment options, please contact our office at 519-913-0318 as this cannot be done online. 
HSLDA Membership Details





Primary Contact Information (The primary contact will receive HSLDA email notifications.)









Secondary Contact if not listed in account name above





**Is this number incorrect? Once your renewal is complete, you can update your info on your HSLDA Member Portal (members.hslda.ca) under “View my Household”.


Update regarding Legal Action Against any of your children



Your Discount Group Details


*By choosing a Discount Group, you give HSLDA permission to confirm, with the registered HSLDA contact of that group, that your HSLDA membership is active. (For group insurance & discount purposes only, no other information will be shared.) 
Review your Membership and Payment Information





Payment Information









5 digit branch or transit #

3 digit institution #(not cheque #)

8-12 digits, include zeros but not dashes, etc

Sample cheque



Hidden Form Specific Fields








Values to Submit to IATS