Membership Form

ACR Membership Groups

Membership Tiers

Tier One – Major companies involved in resource exploration and/or development
Tier Two – Small companies involved in resource exploration and/or development, or supporting companies largely dependent on resource development
Tier Three – Supporting companies moderately dependent upon resource development
Tier Four – Individuals (i.e. retirees, sole practitioners)

Join Between	Tier One	Tier Two	Tier Three	Tier Four
Jan 1 – March 31	$8,550	$1,700	$680	$115
April 1 – June 30	$6,412	$1,275	$510	$86
July 1 – Sept 30	$4,725	$850	$340	$57
Oct 1 – Dec 31	$2,137	$425	$170	$28

Please select your membership category:*

Tier One
Tier Two
Tier Three
Tier Four

Organization Information

Name of Organization*

Address*

Street Address

Address Line 2

City

State / Province / Region

Postal Code

Email

Phone

Fax

We confirm that we will receive electronic communication from the ACR, including but not limited to, updates, event information and registrations, newsletters, save-the-dates and application/committee information. Most communication from the ACR is sent electronically for prompt delivery and cost- effective savings.

Organization Authority

Authorizing Individual

Signing Authority

This indicates the person authorized to sign

Your Information

Contact*

I will be the main contact for all ACR related information
I will not be the main contact (Please fill in information below if name is different than above)

Name and Title

Email

Phone

Untitled

Name

This field is for validation purposes and should be left unchanged.