ONLINE REGISTRATION FORM FOR
2007/2008 ACS MEMBERSHIP

Organization Registration
   

Registration Instructions (or call ACS at 410-715-9545 and we will register you):

  1. Please scroll down and look over the registration form to be sure you have all the information needed to fill out the form. If you do not currently have all the information, please press the "Cancel" button at the bottom of the form and register once you do have all the information.
  2. Please fill in all requested information. ACS uses this information for the annual Directory of Services and for your listing on the website.
  3. Once you have filled in the information, please look back over the form to be sure you have filled in the information correctly. Make any changes needed.
  4. Once you are sure all the information is correct, press the "Submit" button at the bottom of the form. You will be given a receipt and offered the opportunity to either print the receipt and send it in with your check or press a button to pay by credit card through PayPal. If you need to submit an invoice to your organization for payment, please use a copy of the receipt - it will have all the information needed.
  5. If after pressing the "Submit" button you discover you entered information incorrectly, please do not register again. Please call ACS at 410-715-9545 and let us know any changes you need to make.
    Renewal New Member
Organization
  
Address
  
City, State, Zip
 
Phone Number
  
Director/CEO
  
Num. Clients Served
 
Number of Staff
 
Full-Time Part-Time
Organization Type
 
For-Profit Non-Profit Government Faith-Based
Email Contacts - List people at your organization who would like to receive our emails and check what types of email they'd like to receive
Name Email Address
ACS Newsletter
Education & Training Updates
Public Policy Alerts
Director/CEO:        
Additional people to be added to email lists:        
  Additional information for directory and website listing:
Main Contact
 
Contact Email
 
Website Address
 
    Organization description for ACS website listing:
(limited to 75 words)
   
    Please select the search topics that best fit your organization - up to 3
    1.
    2.
    3.
     
    Payment Information
Payment Method
  By Check By Credit Card through PayPal
Dues Level
 
Annual Operating Budget for Howard County
Dues
    Less than $25,000 $75
    $25,001 - $100,000 $150
    $100,001 - $500,000 $225
    $500,001 - $1,000,000 $300
    $1,000,001 - $3,000,000 $450
    $3,000,001 - $5,000,000 $600
    Over $5,000,000 $750
             
    Please be sure that you have followed the instructions and filled in all requested information correctly before pressing the submit button. Do not register more than once.