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Membership Application

Thank you for your interest in joining the Association of Cable Communicators (ACC), serving both cable system operators and programming networks. ACC is the only national, professional organization specifically addressing the issues, needs and interests of the cable industry's communications and public affairs professionals. Its mission is to develop and promote cable communications excellence through professional development to help achieve industry and corporate goals. ACC works to enhance each member's status and influence through skill building and professional development.

Applicant Information:

Please Choose One:
__ Mr.    __ Ms.    __ Dr.   




Street Address

City                                          State                                           ZIP

Phone Number                       Fax Number                              Email

Number of years in the industry _______________
How did you hear about ACC?
    __ FORUM
    __ Beacon Awards
    __ Web Site
            __ Referred By: ___________________

    __ Other: ___________________

Company Type:

__ Cable Network
__ Cable Company; Number of Customers: ___________________
__ State or Regional Association
__ Equipment Manufacturer
__ Consultant/ Public Relations Firm
__ Other: ____________________________________

Occupational Emphasis

please limit your choice to three

__ Affiliate Relation/Sales
__ Community Relations
__ Consumer Affairs
__ Corporate Communications
__ Employee Communications
        __ Government Affairs
__ Investor Relations
__ Marketing Communications
__ Media Relations
__ Production
        __ Public Affairs
__ Public Relations
__ Publicity
__ Reputation Management:
__ Other: _____________________


Please mail completed application and payment of $200.00 to ACC at:
9259 Old Keene Mill Road, Suite #202 Burke, VA 22015,
Attn: Membership Services Coordinator.

Membership (valid for one year) in ACC is not transferable. Membership services will begin in two to three weeks after receipt of this application. After your first year's membership, you will automatically receive a renewal notice at the current individual membership rate.

__ Check
__ Visa
__ Mastercard
__ American Express
        __ Name on Card: ________________________
__ Card #: ________________________
__ Exp. Date: ________________________
__ Authorized Amount: ________________________

Mailing Address: 9259 Old Keene Mill Road, Suite #202   Burke, VA 22015
Phone: 800.210.3396 / 703.372.2215
Fax: 703.782.0153