All fields are mandatory unless otherwise indicated.

Commercial Organisations Name (as found on the IRCM CIC's Commercial Organisations Directory):

Date of change (DD/MM/YYYY):

Reason for change:

New Commercial Organisation Name:
(if the name has not changed, please enter 'no change')

Type of Commercial Organisation:
Enter the type of Commercial Organisation

Country

MAIN CONTACT DETAILS:
If the main contact changes or their details change, please email communication@ircmcic.org with updated details, with your Commercial Organisation name in the Subject line.

Name:
prefix—Please choose an option—MrMrsMissMsDr (medical doctor)Dr (educator)Other (details found in Additional Information box below)
first name
middle name/initial (optional)
last name
suffix (please put each suffix on a new line)

Position held in the Commercial Organisation:

Email:
Your email address will only be used to contact you in relation to your entry on the Directory. If your email address changes, please email communication@ircmcic.org with updated details, with your Commercial Organisation name in the Subject line.

Telephone number:
Your telephone number will only be used to contact you in relation to your entry on the Directory.

COMPANY/ORGANISATION DETAILS:
The fields below are optional and provide you with the opportunity to update the fields with the new information. Where the fields are left blank, it will be accepted that no changes have been made to the details submitted in the original application or in subsequent updates.

Legal Entity Structure:
Please enter the legal entity structure as found on Wikipedia

Company Reference Number as issued by UK's Companies House, HMRC, or other relevant organisations.

Trading Start Date (DD/MM/YYYY)
If this Commercial Organisation has changed its name – either training name or legal name – please enter the date that this new name started trading.

Registered Office Address as registered with UK's Companies House, HMRC, or other relevant organisations:
Country
Address
City/Town
County/State
Post code/Zip code

Trading Office Address:
(If there is more than one Trading Office Address, please email communications@ircmcic.org with the additional addresses, putting the Professional Body name in the subject line.)
This trading office address is —Please choose an option—New.Update of existing address in this location.Other (details found in Additional Information box below)
Country
Address
City/Town
County/State
Post code/Zip code

Logo:
All images will be sized to 250px x 250px, therefore it would be beneficial if you could upload an image that is sized correctly or could be re-sized.) Where you do not upload an image, the system will not display anything.

CONTACT THIS COMMERCIAL ORGANISATION:
Select how you want your Commercial Organisation to be contacted:
—Please choose an option—no changeEmailLink to my websiteOther
Please enter the relevant contact details:
If there are no changes, please enter 'no change'.

DESCRIPTION (optional):

ADDITIONAL INFORMATION (optional):

We confirm that as the main contact, I am providing an update to the information held on the IRCM CIC’s Commercial Organisation Directory on behalf of this Commercial Organisation.

By submitting this form, we give our authority for the information submitted on this form, as well as through other forms and communication methods to be updated in detail on the IRCM CIC's Commercial Organisation Directory.