Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.Please leave this field empty.
Contact Person*
Business Name*
Type of Business*
Number of Employees*
Phone Number*
Email*
Business Address*
Business Postal Code*
Business City*
Business Province*
Length of Time in Business*
Desired Benefits (check all that apply) Life InsuranceHealth (prescriptions, chiropractor, massage, travel medical, etc.)VisionDentalShort-Term DisabilityLong-Term DisabilityCritical Illness InsuranceEmployee Assistance Program
Full Name*
Date of Birth*
Gender*
Occupation*
Province of Employment*
Monthly Income*
Coverage* SingleCoupleFamilyWaive Coverage
Remove EmployeeAdd Employee
Any other information you would like to include:
#10 – 510 45th Street W Saskatoon, SK S7L 7L1
Phone: 1-888-523-7208
Email: info@auroraworkplace.ca
101 – 2022 Cornwall Street Regina, SK S4P 2K5
Phone: 1-306-552-6898