2025/2026 ACSIWC Higher Education New Member Registration
Thank you for your interest in ACSI membership! We are so glad you are here! It is important that all information be current and complete because this information affects services to your school. If you have questions or you require adjustments to totals, submit your form as is and contact Denise at denise_daniel@acsi.org. Note Denise only works Fridays so response may be delayed.
School Information
Institution Name
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Office Email
*
example@example.com
Physical Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Mailing Address (if different than above)
Mailing Address
Mailing Address Line 2
City
Province
Postal Code
Upload a photo of your school to be used in communication and social media.
*
Browse Files
Drag and drop files here
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Administration
Main Email
*
example@example.com
Representative authorized to vote on behalf of institution
*
First Name
Last Name
Voting Rep Email
*
example@example.com
ACSI Liaison Name
*
First Name
Last Name
ACSI Liaison Job Title
*
Head of School, Principal, etc.
ACSI Liaison Email
*
example@example.com
President Name
*
First Name
Last Name
Please list any benefits you offer to ACSI member school students, such as scholarships, reduced student event fees, etc.
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Staff and Student Enrollment
FTE: Full Time Equivalent
Number of full-time professors
*
Number of part-time professors
*
Total Enrollment
*
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Membership Fees
As a new member, you will receive a 50% discount on your first year of membership fees. This is reflected in the total below.
Range 0-250
Range 251-500
Range 501-1000
Range 1001-1500
Range 1501-2000
Range 2001+
Total Fees Due
Payment Information
New payment option this year — pay by e-transfer or cheque!
E-transfer
Send to payments@acsiwc.org. Be sure to include the name of your school and what the payment is for (i.e. Membership) in the description.
Cheque
Send to ACSIWC, 44 Willow Brook Drive NW, Airdrie, AB T4B 2J5. Be sure to include the name of your school and what the payment is for (i.e. Membership) in the description.
Signature
I have read and agree with the ACSIWC Statement of Faith: https://www.acsiwc.org/statement-of-faith
*
Yes
No
Signature
*
Name of Signee
*
First Name
Last Name
Email Address of Signee
*
Job Title of Signee
*
Form Completed by
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
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