 |
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
| |||
|
|
|
|
|
|||
|
| |
Membership Registration Form
Mail to ACR-NC
PO Box 18301
Raleigh, NC 27619-8301
www.acrnc.org ¬ info@acrnc.org
1-866-NC-ACR-NC (1-866-622-2762)
CONTACT INFORMATION (Check here ___ if you would like your contact
information inlcuded on ACR-NC's website)
|
First Name |
|
|
Middle Name |
|
|
Last Name |
|
|
Suffix |
|
|
Title |
|
|
Organization |
|
|
Address 1 |
|
|
Address 2 |
|
|
City |
|
|
State |
|
|
Phone – office |
|
|
Phone – home |
|
|
Phone – cell |
|
|
Fax |
|
|
|
|
|
Web Site |
|
|
Are you a member Of ACR National?
* Yes * No |
By becoming a member of ACR-NC, you agree to honor the ACR Standards of Practice. Information about Standards of Practice can be found at: www.ACRnet.org |
Please check the top 3 expectations you have (or hope to gain) as a member of ACR-NC. o Networking with other professionals o Training opportunities (CEU, CLE, etc.) o Skill development in new areas o Increase visibility in the profession o Advocacy for the ADR field o Other: _______________ (specify)
MEMBERSHIP INFORMATION - Dues cover annual membership year
(January 1-December 31).
· Regular: One must be a member of ACR national in any category of membership, whose ACR dues are current. Member may serve as a director or officer in ACR-NC and have full Chapter voting privileges.
· Affiliate: An individual not holding membership in ACR, who has agreed to abide by ACR’s ethical standards and to support ACR’s Mission and Guiding Principles. Affiliate shall have voting privileges
on Chapter issues, elections and may serve on committees.
· Student: Student or youth members are eligible to be regular members of ACR-NC or Affiliate members of ACR-NC. Please provide student ID.
|
CHOOSE ONE |
DUES |
|
|
$25 Regular or Affiliate |
|
|
$15 Student, Volunteer, or Additional Organizational Member |
|
|
$50 Organizations can sponsor members: Up to three individuals may join through an organization at the $50 rate, when the organization provides conflict resolution services directly to individuals or communities. Additional members can be added at the $15 rate. Please provide a registration forms for EACH of your organization’s member. |
ACR-NC form revised 12-07
|
This site managed with Dynamic Website Technology
from Mediate.com Products and Services InstantAssist.com Conflict Consultation |