Corporate Partner Application Company Name Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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 - $6,000/yr Diamond - $5,500/yr Gold - $5,000/yr Silver - $4,500/yr Bronze - $4,000/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.