Company Name: Mailing Address:
2021 Tier Selection (select one):
Tier 1 -- $200,000 - $500,000 in dues. Executive Committee, Policy and Strategy Committee and Board representation.Tier 2 -- $100,000 - $199,000 in dues. Policy and Strategy Committee and Board representation.Tier 3 -- $25,000 - $99,000 in dues. Board representation.Associate -- $2,000 - $24,999 in dues, Board meeting attendance.
2020 Dues Commitment : 2021 Dues Commitment :
By initialing, I commit my company to America’s Power membership for 2021 and agree to pay dues according to the established dues schedule.
Signature: Name: Title: Email: Date:
Thank you for your continuing support of America’s Power (ACCCE) and your commitment for 2021. Under our governance structure, Tier 1, 2, and 3 members receive a seat on the Board of Directors; Tier 1 and 2 members receive a seat on the Policy and Strategy Committee; and Tier 1 members receive a seat on the Executive Committee. Associate members may designate someone to attend Board of Directors meetings. Members may also designate alternates where noted.
The same person is allowed to serve in various roles. However, the Executive Committee member must be the CEO of your company or, if approved by the Executive Committee, a senior executive. We request that the representative on the Policy and Strategy Committee be a senior executive. The representative on the Board must be the President of your company or another similar senior executive.
Using the form below, please provide us with the name(s) of the individual(s) who will represent your company in these various roles. If you have questions, please contact Michelle Bloodworth at mbloodworth@americaspower.org.
Name of Board Member: Title: Name of Board Alternate (Optional): Title:
Name of Voting Member: Title: Name of Board Alternate (Optional): Title:
Name of Committee Member: Title: Name of Board Alternate (Optional): Title:
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