ACU

Contact Info:  Website www.acu100k.com    

MEMBERSHIP FORM/ FORMULAIRE D’ADHÉSION DES MEMBRES
Registration Instructions
  1. Enter the required information below.
  2. Confirm the information you entered and get total to be charged.
  3. Enter your credit card information.
  4. Transaction is processed and a receipt is emailed to the address you supplied.
  5. If there are any questions about your online registration please contact us at acu@onlineregistrations.ca.

All fees non-refundable and non-transferable.
Required information is marked with a red asterisk (*).

Choose One Fees/Frais d'adhésion
1 year/an $30.00
2 years/ans $60.00
* A transaction fee will be applied.
Enter Your Personal Information
*Choose One: Renewal /Renouvellement New Member/Nouveau Membre 
*First Name/Prénom:
*Last Name/Dernier nom:
*Email /Courriel: home: (your receipt will be emailed to this address)
office:
*Phone/Téléphone: home: ( )-
office: ( )-
*Gender/Sexe: female        male
*BirthDate/Date de Naissance:
*Street/Rue: Apt #
*City/Ville:
*Prov./State:
*Country/Pays:
*Postal Code/Code Postal:
 
 

Registrations Processed by OR