ACDA MEMBERSHIP APPLICATION

My desire to become a member of ACDA,
Adherence to the code of ethics supported by the National Career Development Association, and
Agreement that my program RSVPs carry the responsibility of payment unless I cancel at least
72 hours in Advance. (Reservations are transferable)

Please select the Tab key after adding your application details. If you hit the enter key before adding all of your information, use the back arrow to go back and complete your registration details before submitting.
MEMBERSHIP STATUS: past member new member

DUES – Membership Year is August 2012 through July 2013
BENEFITS – Education programs on various topics of interest to our members in their work with students and clients are offered on location (quarterly) and by audio teleconferencing and/or a download (montly). Opportunities to develop networks with career professionals at each on location educational program.
Individual Membership	Individual Membership $30
Organizational Membership (for 3 or more applicants from the same employer, per person, see instructions below). Organization Name: Number of applicants: (Fill out a separate online form for each membership and submit all applicaitons within a 24 hour period. All submissions are time stamped when submitted. Either make a secure payment online for each submission, OR mail the membership application for each applicant in the same envelope along with total payment.)	Organization Membership $25
Student Membership (for those in full-time studies, may not hold office or vote in ACDA matters)	Student Membership $25



COMMUNICATION

ACDA communication is done electronically. Can you receive/send e-mail and access the Internet?

Yes, I can No, I must receive printed copies

MAILING LABEL AND DIRECTORY INFORMATION
May we include your contact information in our online website Membership Directory?	Yes	No

*Information that will go into the website’s online Directory. Providing the other requested information is optional.
First Name Last Name		*Title

Employer/Organization Title/Position

*Address
*City	State	Zip Code

* Phone		Fax
*E-Mail Address
Highest education (degree, major ) Licenses and Certifications Specialties, client base, expertise, etc
Todays Date






ACDA members are encouraged to join the National Career Development Association (NCDA)
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