Advocacy Interest Membership (Application/Affirmation – 2023)

Participating in Government Affairs Committee
Participation in GAC meetings and activities–including receiving ACPA legislative and regulatory updates–now requires ACPA members and affiliates to complete an Advocacy Interest Membership form annually. The form is provided below.

There are no additional dues associated with this membership classification, but membership will follow certain the operating guidelines stringently. Participation also allows ACPA PAC activities to be reported and acted upon without encumbrances.

PLEASE COMPLETE THE FOLLOWING CONTACT INFORMATION:

First Name:*

Last Name:*

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone:*

Area Code

Phone Number

E-mail:*

PLEASE INDICATE THE NAME OF THE ACPA MEMBER COMPANY YOU WORK FOR:

COMPANY/FIRM NAME: *

YOUR JOB TITLE:*