MEMBERSHIP APPLICATION - ALBERTA COMMUNITY & CO-OPERATIVE ASSOCIATION

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1 MEMBERSHIP APPLICATION - ALBERTA COMMUNITY & CO-OPERATIVE ASSOCIATION Thank you for taking an interest in joining the Alberta Community and Co-operative Association (ACCA). Applications for membership are reviewed by our Board of Directors. As a member organization, this form also provides our staff with the necessary information to keep you up to date on ACCA activities, opportunities to get involved, and information that could be shared on our website as part of our member directory. This membership application form also lets us assess how we can best support your organization. The ACCA meets the needs of its members through its strategic objectives: Being financially sustainable Foster co-operative awareness and relationships Facilitate the growth and development of member co-operatives Build and maintain a respected identity Alberta s co-operative movement has deeps roots and a bright future. We look forward to having you join our association as a member. If you have any questions, please do not hesitate to contact the ACCA. Organization Information Date of incorporation (yyyy/mm/dd): Mailing Address: City/town: Province: Postal Code: Number of Members: Number of employees: Links: Website: Twitter: Facebook: Instagram: LinkedIn:

2 ACCA Contact Person within your organization: (they will be the point of contact for membership and receive all key communications and share these within your organization as appropriate) Marketing/Communications Contact within your organization: (they will be the point of contact to create your online member profile and member spotlight article. They will also be the contact to share any key messages/events with us that you are organizing) Additional Key Contacts (i.e. Board Directors/Secretary, CEO s, EA s, Finance, VP s etc.) The mission and goals of our organization are: (please provide a URL or attach a copy of your Strategy and/or Annual Report)

3 Our members, stakeholders, and groups we work with include: What is your reason for joining ACCA? Please provide your Board Meeting & AGM Dates for the next 12 months: Are you willing to share your contact information with other ACCA members? Yes No We would like the following staff, board or volunteers on the ACCA communication list (to receive regular newsletters, notifications, invitations)? Name (first and last) Job Title Phone Number address Co-operative Services ACCA offers a variety of services and holds events throughout the year. Let us know what services your organization would like to learn more about? Please check all that apply. Co-operative Education and Training Government Relations ACCA Events (Gathering etc.) Co-operative Youth Leadership Development Cross-sector Collaboration Career Focus Internship Program Other (let us know how we can help your organization):

4 Volunteer Opportunities There are several ways to get involved in building strong communities, and to gain valuable leadership development skills. Let us know if your organization would like to get more involved in this work Join the ACCA Board and/or committee Volunteer staff at the co-operative youth leadership program Learn more about the ACCA Leadership Foundation Volunteer at ACCA events Other (please list): ACCA wants to know what issues are important to you and your organization, and how we can help your organization achieve these goals. Please list the top three issues, challenges, or opportunities, facing your organization Additional comments:

5 We are applying for the level of membership indicated in the table below: ACCA MEMBERSHIP CATEGORIES AND RATES Organization Annual member dues Apex Organizations (10 employees or less) $2, Members outside the sector $2, REAs and Gas Co-ops $1, minimum or $0.185 per member Member Credit Unions $0.185 per member Retail and Consumer Co-ops $0.185 per member Agriculture + Producer Co-ops $1, Human Services and ODCs $ Authorization: As a representative of the organization herein applying, we the undersigned, declare that the information in our application is true and accurate. We understand that when our application has been approved, 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. Signed: Print name: Date: MAIL, FAX OR APPLICATION TO: Alberta Community and Co-operative Association #201, Street Stony Plain, Alberta, T7Z 1L5 Telephone (780) Fax (780) info@acca.coop