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: $960

COMPANY PROFILE
Number of offices in Canada:
1. Permanent placement/search services must provide their provincial license where applicable:
Class:
Number:
2. Temporary help companies and contract providers must supply WSIB/WCB (CSST) clearance certificate.
Clearance Certificate Number:
3. For companies/locations with more than 5 full-time employees, please provide the name of the Health and Safety representative (if provincially).
Name:
Phone:
Note: It is mandatory that all offices providing staffing/recruiting services be included in the corporate profile.
DUES PAYMENT
Membership year is January 1 to December 31. Dues are subject to HST/GST (#871631198) and must be submitted with the application. 1st office: $960 2nd office: $730 3rd and each additional office: $670/each 23rd office to 42nd office: $625/each 43rd office to 62nd office: $575/each 63rd office and each additional office: $450/each

Company Name:
Authorized Representative/Principal Contact:
Salutation:
First Name:
Last Name:
Title:
Address:
Suite:
City:
Province:
Chapter:
Postal Code:
Telephone:
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):