ACSESS Membership Registration

AFFILIATE MEMBERSHIP INCLUDES:
Company added to ACSESS databases to receive ACSESS industry materials. Invitations to sponsor events, including seminars, conferences, shows. Opportunity to promote company services to ACSESS members electronically, in print materials, and at ACSESS events. Opportunity to partner with ACSESS on specific value added services for Corporate members.
DUES PAYMENT
Membership year is January 1 to December 31. Dues are subject to HST/GST (#871631198) and must be submitted with the application. Affiliate Membership: $1100

Company Name: *
Authorized Representative/Principal Contact:
Salutation:
First Name: *
Last Name: *
Title:
Address: *
Suite:
Country: *
Province/State: *
City: *
Chapter: *
Postal Code: *
Phone: *
Fax:
E-Mail: *
Invoice E-Mail (Above Email will be used if left blank):
Website:
Language Preference: *	English French
Electronic Correspondence: *	I agree to receive electronic correspondence I DO NOT wish to receive any electronic correspondence

BUSINESS INFORMATION
Federal BN: *
Year business commenced: *
Head office in Canada:	Yes No
Are you a member of any other industry organization?: *	Yes No If yes, please list:
How did you hear about ACSESS?: *
What is your primary reason for joining ACSESS?: *
List the type(s) of staffing services your firm provides (Please separate multiple by commas):