Today’s date: Click here to enter a date.Date list needed by: Click here to enter a date.
(Minimum 2 weeks/10 working days required)
REQUESTOR:
Name: Click here to enter text Email: Click here to enter text.
FILE FORMAT/OUTPUT: Comma delimited, in excel format; zip code order is the default (for foreign and US, the order is country, then zip)
FILE LAYOUT: CustomerID, Prefix, FirstName, MiddleName, LastName, Suffix, AddressCompany, DeptMailstop, AddressLine1, AddressLine2, City, State, PostalCode, CountryName, CountryCode, PrimaryEmailAddress, textbox18 (membership type)
FILE WILL BE DELIVERED VIA eMAIL
Division name: Click here to enter text. Division code: Click here to enter text.
Sub-Division name: Click here to enter text. Sub-Division code: Click here to enter text.
REQUIRED:
☐ I confirm that I have checked the Bylaws for ACS elections or for my particular division, and that this data only list request conforms to all requirements. (check the box to signify your agreement)
FILE TO BE eMAILED TO:
Division/Sub-division Officer Name: Click here to enter text.
Division/Subdivision Officer Title: Click here to enter text.
Email : Click here to enter text.
NOTE: When you submit this form, you acknowledge and agree thatdata provided may be used only once for the purpose stated, and may not be retained, shared, or duplicated in whole or in part.
LAST STEP: Rename this form and return it as an email attachment to: . Questions about division or sub-division requests? Call 202-872-4557.
Automatic default, etc.
Automatic default settings are in bold; however, some boxes have already been checked for the majority of divisions for elections, according to division Bylaws. Be sure to check your division Bylaws and check boxes below to make selections in accordance with those Bylaws.
Promo Block Codeis for those people who have asked not to receive promotional mailings. NOTE: The default for elections is to INCLUDE those members with promo blocks.
☒ I want all eligible members to receive this mailing; therefore, include all eligible members who requested
a Promo Block Code.
Division Membership Type= Default is All division members except Division Affiliates. Deceased or resigned members re not included.
☐ Division Members
☒ Division Emeritus
☐ Division Affiliates