Application for Membership - Associate Member 

Commercial organizations providing goods and services and supporting the policies, purposes, and activities of ACUI are eligible for associate membership. Each associate membership specifies one individual to be the main contact person between the member and ACUI. Additional representatives of an associate member can receive the same mailings as the main contact with the Associate Plus package. This package costs $75 per additional person and is renewable on the anniversary date of original payment. The company must have an associate membership to be eligible for the Associate Plus package.

Please complete the form below. You will be contacted within one business day for your payment information.

Name of primary contact:   
Mailing address:     
Email address:   
Web address:   
Name of marketing/
communications contact:
Phone number:       
Email address:   
Please share with us how
you heard about ACUI or
why you decided to join?
Please use the space below to add additional representatives through the Associate Plus package. Each additional person added is an additional $75. Please include name, title, mailing address, phone, and e-mail address.

Once submitted, you will be contacted at the phone number above for your payment information.
Membership will start immediately upon payment.

If you have any questions or want to verify any details,
please do not hesitate to contact us at 812.245.ACUI (812.245.2284).