Company name:
Principal Contact:
Title:
Address:
Suite:		City:
Province:		Postal Code:
Telephone:		Fax:
E-Mail:
Website:
Federal BN:
Head office in Canada:	Yes     No
Language Preference:	English     French
BUSINESS INFORMATION AND COMPANY PROFILE
Services provided (for example, printing):
1:
2:
3:
4:
Company profile (for website listing):
How did you hear about ACSESS?
What is your primary reason for joining ACSESS?
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 serv- ices for Corporate members.
DUES PAYMENT
Membership year is January 1 to December 31. Dues are subject to 13% HST (#871631198) and must be submitted with the application. Affiliate Membership: $795 How would you like to pay? Cheque (please make cheque payable to ACSESS) VISA     MasterCard     AMEX
Authorization The undersigned hereby applies for membership in the Association of Canadian Search, Employment & Staffing Services (ACSESS). I, on behalf of my company, hereby pledge to adhere to the Code of Ethics & Standards of ACSESS in the best interests of the industry and the public that it serves.
Authorized signature:
Date:	7/31/2010 8:00:37 AM