Corporate Partner Application Company Name Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneFax Website PRODUCT / SERVICE DESCRIPTIONPlease describe your businessMain Contact Title Secondary Contact Title REFERENCE (OPTIONAL)Name Reference AAC Member Professional Association PhoneEmail CORPORATE PARTNERSHIP LEVELS (select one)Product Name Platinum - $10,600/yr Diamond - $9,400/yr Gold - $8,600/yr Silver - $6,600/yr Bronze - $5,800/yr **All convention exhibitors must become a corporate member.Total Cancellation Policy: 45 days + = 50% Refund Under 45 days = No Refund NO EXCEPTIONS By submitting this application, you are agreeing to abide by the AAC Corporate Partner Policy. *Membership rates may change at any time.
