Check One: Full Member Associate Member

              Firm Name: 
  Headquarter's Address: 
        Address (cont.): 
                   City: 
         State/Province: 
        Zip/Postal code: 
                Country: 
                  Phone: 
                    Fax: 
       Internet Address: 

 Principal Contact Name: 
                  Title: 
                  Phone: 
                    Fax: 
                 E-Mail: 

 Alternate Contact Name: 
                  Title: 
                  Phone: 
                    Fax: 
                 E-Mail: 
     

All Information must be completed

1. Date on which the firm was founded?
   
   
   
2. Years providing career management consulting professional services including outplacement?
   1. If less than 2 years you may qualify for Associate Membership.
      
   
   
   
3. Has the firm previously done business under any other name?
   Yes No
   
   
   1. If Yes, please provide prior firm name and dates: (attach additional sheets as necessary)
      
   
   
   
4. Is your firm a subsidiary of another organization?
   Yes
   No
   (If yes please attach parent company information brochure.)
   
   
   1. If yes, please provide the parent organization name:
      
      
      
5. Company Information:
   
   
   1. Total full-time salaried professional staff?
      
      
   2. Number Professional staff with two or more years career management consulting experience principally engaged in this activity today.
      
      
   3. Number of support staff
      
      
      1. Note: You may be eligible for Associate Membership if staffing, experience, and activity requirement is not met. Associate Membership is reviewed every two years.
         
      
      
6. How many offices does your firm have?
   Total North America Europe Other International
   
   
7. Confirm your firm has adequate resources to continue in business for the next 12 months?
   Yes No
   
   
8. Does your firm accept fees paid by individuals for outplacement services?
   Yes No
   
   
9. List the consulting services your firm provides:
   

   	Name of Service	Percent of Total Business
   1.
   2.
   3.
   4.
   5.

   
   
10. What is the range of your firm's revenues in the past two years?(Please check one)
    Less than $500,000 $500,000-$1,000,000 $1M-$2M
    $2M-$5M $5M-$20M Over $20M
    

I have read the ACF International Bylaws including the Standards of Professional Practice and Code of Ethics,plus the summary of membership conditions and my firm understands and supports them. I understand that member firms undertake outplacement work only from corporations and organizations. Fees are only accepted from individuals commissioning outplacement services for themselves (retail outplacement) where the member firm has different premises, different professional staff and trades under a different name.

Authorized Firm Representative Signature:

Date:

Dues are based on the number of offices your firm has and their location. Dues payment should accompany this application. Dues are for 12 calendar months from the date received.

1. ACF International - each dues share = $220.00
   
2. International - each dues share = $500.00 (International Chapter covers South America, Asia/Pacific and Africa where there are currently no chapters)
   
3. ACF International Europe Chapter = $500 for headquarters office and $150 for each branch office in Chapter area.
   

Examples: A company with a total of 5 offices worldwide (5 North America) pays annual dues of $1,220 ($1000 North America Chapter + $220 ACF International). A company with 5 offices worldwide (4 North America and one International) pays annual dues of $1,720 ($1,000 North America Chapter + $500 International + $120 ACF International). A company with a headquarters office in Europe and 12 branches in Europe pays $2370 ($500 Europe Headquarters Office plus $1,650 for 11 Europe branches + $220 ACF International).

The Association of Career Firms International (ACF International) reserves the right to request further information from membership applicants for the purpose of confirming the information contained above. Processing your membership application requires 45-60 days. If you are not accepted for membership, your payment will be refunded less a $200 administrative fee. Please note: We have regional chapters for North America and Europe. Depending on the location of your headquarters office, your application will either be reviewed by the regional Board of Directors and then the ACF International Board, or solely by the ACF International Board.

Please mail your application and dues payment to: ACF International, Attention: Annette Summers, Executive Director 204 E Street N.E. Washington, D.C. 20002 Voice: 202-547-6344 Fax: 202-547-6348 Email: als@acfinternational.org

Credit Card Payments: American Express MasterCard Visa
Expiration Date:

Name on Card:

Card No.

Amount of Authorized Card Payment: $

Signature

Note: If you do not meet full membership requirements at this time, you may be eligible for Associate Membership, which is reviewed after two years. Dues for Associate Members are the same as for Full Members. The membership application is the same. Simply indicate Associate Membership at the top of this page.