Northern NE Associates App

ACA/NE Non-Contractor Membership Application Form

Northern New England

MEMBERSHIP INFORMATION:

Company

Street/P.O. Box *

City

State * Zip Code *

Website

Phone *

Key Contact

Title

Cell

Yes, I wish to serve on the ACA/NE Northern New England Chapter Leadership Group.

Second Contact

Title

Cell

Yes, I wish to serve on the ACA/NE Northern New England Chapter Leadership Group.

How did you find out about ACA/NE?

MEMBERSHIP DEMOGRAPHICS AND PAYMENT:

Corporate Members: Distributor, Wholesaler, or Manufacturer’s Rep

Associate Members: Private career school, or any person, firm, partnership, company or corporation that provides a non-HVAC related service to HVAC contractors. Examples include accountants, lawyers, insurance companies.

If your company is already an ACA/NE member, the membership dues for ACANNE is reduced by 50%.

Check One:

Corporate = $1,000	Current Corporate Member = $500
Associate = $400	Current Associate Member = $200
Vocational School or Instructor = $100	Current Vocational School Member = $50
Student - $50

Total Fees

Payment* Master Card VISA American Express

Account Number

Security Code* Expiration Month*Expiration Year*

First Name

Last Name* Email* Billing Zip Code*

ACANE dues are not deductible as a charitable contribution for federal taxes, but may be deductible as a business expense up to 62%.

ACA/NE | 11 Robert Toner Blvd., # 234 North Attleboro, MA 02763 | Phone: 508-839-3407 | katie@acane.org

ACA/NE and ACA/NNE are not a part of, or affiliated with ACCA, which is a national association.