Personal Debt Solutions Canada - Membership Application

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Apply to become a PDSC Trustee

Personal Debt Solution Canada (PDSC) is a network of professional Canadian bankruptcy and insolvency trustees who have come together to provide Canadians a resource they can trust. If you are a trustee with proper credentials and you wish to apply to become a member, simply fill out the form below.

Membership Includes:

Please fill out the form below. The PDSC membership will review your request and contact you regarding your application in the next 48 hours

* are required
*Full Name:
*Email Address:
*City:
*Province:
*Postal Code:
Website:
*Phone:
Fax:
Cell Phone:


Type the code you see on the image below:

Security Code



Please enter your name.
"; $bad = "true"; } if ($email == "") { echo "
Please enter your email.

"; $bad = "true"; } if (($email) && (filter_var($email, FILTER_VALIDATE_EMAIL) === FALSE)) { echo "
Please doublecheck your email address.

"; $bad = "true"; } if ($city == "") { echo "
Please enter your city.

"; $bad = "true"; } if ($province == "") { echo "
Please enter your province.

"; $bad = "true"; } if ($postal_code == "") { echo "
Please enter your postal code.

"; $bad = "true"; } if ($phone == "") { echo "
Please enter your phone number.

"; $bad = "true"; } if ($_POST['userSecurityCode'] != base64_decode($_POST['SecurityCode'])) { echo "
Please enter the security code again.

"; $bad = "true"; } ?> Thank You,
Application Successfully Sent!

"; //for now the email goes to collee's email, it can be changed but they need to specify where to send it. $email_to = "colleen@cecraig.com"; $header.= "From: $full_name <$email>\n"; $header.= "X-Sender: " . "$email\n"; $header.= "Return-Path: " . "$email\n"; $subject = "This is a PersonalDebtSolutionsCanada.com New Member Application Signup"; $message = "\n\nName: ".$full_name."\n\n"; $message .= "Email Address: ".$email."\n\n"; $message .= "City: ".$city."\n\n"; $message .= "Province: ".$province."\n\n"; $message .= "Postal Code: ".$postal_code."\n\n"; $message .= "Phone: ".$phone."\n\n"; if ($website) { $message .= "Website: ".$website."\n\n"; } if ($fax) { $message .= "Fax: ".$fax."\n\n"; } if ($cell) { $message .= "Cell Phone: ".$cell."\n\n"; } $message .= "Was sent from this URL: http://".$_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; mail($email_to, $subject, $message, $header); //this sends a message to the contact $header.= "From: PDSC \n"; $header.= "X-Sender: " . "info@personaldebtsolutionscanada.com"; $header.= "Return-Path: " . "info@personaldebtsolutionscanada.com\n"; $subject = "Thank you for applying to the Personal Debt Solutions Canada Network"; $message = "\n\nYou sent the following:\n\n"; $message .= "Name: ".$full_name."\n\n"; $message .= "Email Address: ".$email."\n\n"; $message .= "City: ".$city."\n\n"; $message .= "Province: ".$province."\n\n"; $message .= "Postal Code: ".$postal_code."\n\n"; $message .= "Phone: ".$phone."\n\n"; if ($website) { $message .= "Website: ".$website."\n\n"; } if ($fax) { $message .= "Fax: ".$fax."\n\n"; } if ($cell) { $message .= "Cell Phone: ".$cell."\n\n"; } mail($email, $subject, $message, $header); //Sends copy to me for tracking purposes. $EmailContentForDavid = "$message\n"; $EmailContentForDavid .= "Sent from http://www.PersonalDebtSolutionsCanada.com/member_application.php/\n"; mail("davebruning@gmail.com","Copy of sent message: ".$subject,$EmailContentForDavid,"From:".$full_name." <".$email.">"); } } //end if submit //----------------------------------------------------------------------end of form has been filled out ----------------------------------------------------- ?>