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For Individual Members Only
Member Information
Name: Click here to enter text.
Email: Click here to enter text.
Position: Click here to enter text.
Organization Information
Organization: Click here to enter text.
Organization Address:Click here to enter text.
City, State, Zip: Click here to enter text.
Training Requirements
Are you interested in receiving training through the ACL Users Group?:
Yes No
List type of training or User Group meeting topics you are interested in:
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Organizational Systems
List relevant applications used by you or your organization (i.e. SAP, PeopleSoft, etc.):
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Membership Fees – Due April 15, 2018
$45 New Membership = $25 application fee + $20 annual 2018 dues (no prorating)
$20 Individual Renewal for January 1 to December 31, 2018
Payment Options
Select one option:
Email me an invoice for online credit card payment. Email this form to

Mail check made payable to Virginia ACL Users Group and attach form(s) to:
Virginia ACL Users Group
P.O. Box 8195
Fredericksburg, VA 22404-8195
Questions:
Signature of Member: Click here to enter text. Date:Click here to enter text.
For Organizational Memberships Only
NOTE: Organizational Members do not pay any application fee.
Organization Information
Organization: Click here to enter text.
Organization Address: Click here to enter text.
Contact name: Click here to enter text.
Contact E-mail: Click here to enter text.
Training Requirements
Is your organization interested in receiving training through the ACL Users Group?:
Yes No
List type of training or User Group meeting topics your organization is interested in:
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Names of all ACL registered users covered by Organizational Membership
Name / Email Address
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Organizational Membership Dues (check one selection)
3 to 4 inclusive = $100 9 to 10 inclusive = $200
5 to 8 inclusive = $150 Over 10 = $250
Select one option:
Email an invoice for online credit card payment. Email this form to
. (Invoice will be emailed to primary contact.)
Mail check made payable to Virginia ACL Users Group and attach form(s) to:
Virginia ACL Users Group
P.O. Box 8195
Fredericksburg, VA 22404-8195
Questions: email
Signature of Primary Contact: Click here to enter text. Date:Click here to enter text.