Organization Name
*
Incorporation Date
*
MM
DD
YYYY
Mailing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Number of Members
*
Number of Employees
*
Name & Email of Person Submitting
*
Phone of Person Submitting
*
(###)
###
####
Facebook
LinkedIn
Instagram
Mission & Vision
*
Please outline your mission and vision (URL's welcome)
Our members, stakeholders and groups we work with include:
*
Reason for joining ACCA?
*
Top 3 Issues/Challenges/Opportunities Facing Your Organization
*
ACCA wants to know what issues are important to you and your organization, and how we can help you achieve these goals.
Board Chair Email
*
Board Chair Phone
*
(###)
###
####
When's your next AGM?
MM
DD
YYYY
When's your next board meeting?
MM
DD
YYYY
Co-op Services
*
Let us know what ACCA services your organization would like to learn more about? Please check all that apply.
Volunteer Opportunities
*
There are several ways to get involved in building strong communities, let us know if your organization would like to get more involved in:
Additional Comments
Authorization
*
As a representative of the organization herein applying, I declare that the information in our application is true and accurate. I understand that when our application has been approved by the board, the Alberta Community and Co-operative Association will send us an invoice for our prompt payment by cheque, MasterCard, or VISA. We also understand that the Alberta Community and Co-operative Association will send us an invoice for the
annual renewal of membership, 12 months from date of membership approval.
Other Key Contacts
In addition to providing your point of contact to receive and distribute ACCA member communications within your organization. Please nclude other primary contact info Board Directors/Secretary, CEO/ED, Finance, etc.
