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

Comments

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