JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ACEVic Membership Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Membership Information
Organisation Name
*
Your answer
The following information required is for new applicants
Street address
Your answer
Postal address (if different to street)
Your answer
Email
Your answer
Website URL
Your answer
Facebook address
Your answer
Following information requested is for all applicants
Do you allow for ACEVic to share your posts on our social media page?
*
Yes
No
Total revenue for the last financial year
*
Your answer
Manager / Co-ordinator / CEO details
Name
*
Your answer
Position
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Please provide details of any other staff that you would like to receive our newsletter updates
Name
Your answer
Position
Your answer
Email
Your answer
Name
Your answer
Position
Your answer
Email
Your answer
Is your organisation registered with the ACFE Board?
*
Yes
No
Do you use Coverforce insurance? (If yes, you should be receiving a discount as an ACEVic member)
Yes
No
Clear selection
Do you have amongst your principal purposes the provision and/ or support of learning opportunities for adults?
*
Yes
No
Do you agree with ACEVic's purpose?
*
Yes
No
If you have any questions or comments for ACEVic, please provide details.
Your answer
Thank-you for your membership registration.
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
