OSI Registration Request Form - General Information

The Internet is a public forum and electronic information can be intercepted. This is not a secure Web site. Please do not disclose unnecessary confidential information about yourself or your accounts with PWGSC.

Privacy Notice Statement

Provision of the information is on a voluntary basis. We will use the information for the purpose of responding to your questions/comments, and to improve our Internet presence.

The information will be held in Public Works and Government Services Canada's Personal Information Bank number PPU 115 (Internet Services), and it will be retained according to the retention and disposal schedule established for this bank.

Your personal information is protected under the provisions of the Privacy Act. Under the Act, you have the right to request access to and correction of your personal information, if erroneous or incomplete.

For more information about your rights, see Info Source. This is a Government of Canada publication available in major libraries, at government information offices and from constituency offices of federal Members of Parliament.

Organization Information
Organization Name:
Organization Acronym:
Incorporation Number (if applicable):
Province/federal Incorporation:
Business Classification:
Street Address or Post Office Box:
City:
Province:
Postal Code:
Country:

If your organization has previously registered any information object, please indicate the type and specify its value
NSAP org-ID:
Object Identifier:
Directory Name:
ADMD/PRMD:
Value of any one of the objects already registered:

Requester Information
Surname:
Given Name:
Initials:
Title:
Phone Number:
Extension:
Fax Number:
E-mail Address:

OSI Registration Request Form - General Information Organization Contact Information
Surname:
Given Name:
Initials:
Title:

Division/Mail Stop:
Street or post office box address:
City:
Province:
Postal Code:
Country:

Phone Number:
Extension:
Fax Number:
E-mail Address:
COMMENT: Optional comment appended to registry data (150 characters maximum):

COSIRA/GORA reserves the right to suspend service from any registered organization.
COSIRA/GORA will process this application with due care and diligence; however, COSIRA/GORA will not be liable for any errors that occur during the processing of this application.

I agree to the limits of COSIRA/GORA liability as set out above, and certify that:
a. the information provided in this application is correct to the best of my knowledge; and
b. the organization for whom I am submitting this application has the rights to use the object identifier component name being registered.