Associate Member Application

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Associate Member Application
Name*

First NameLast Name
Title*
Company*
Department
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area Code
Fax Number

Area Code
Email*
example@example.com
Primary Business Model*

Third-Party Service ProviderThird-Party SenderHardware Service ProviderSoftware Service ProviderOther
If you are a Third-Party Sender and facilitate payments:
How many Originators do you have?
How many payments do you originate annually?
How did you hear about EPCOR
EPCOR DUES INFORMATON

Annual Associate Membership dues are assessed at the beginning of each calendar year. Dues are automatically renewed each year unless written cancellation is received 30 days in advance. Annual dues may be paid by check, or you can request an invoice.

Annual Associate Member Dues - $1,225
Please select the method in which you would like your dues to be paid:*

Invoice MeCheck (payable to EPCOR)
** EPCOR reserves the right to disassociate itself from any organization that, in our opinion, fails to abide by our Code of Conduct or otherwise brings discredit to EPCOR and/or the payments profession. I understand that by providing my email and fax number, I consent to receive email and faxes sent by EPCOR. I understand that EPCOR will not share my email or fax number with other organizations.

Fees for seminars, conferences, dues, materials or services paid to EPCOR, a not-for-profit corporation, may be deductible for members for federal income tax purposes as ordinary and necessary business expenses. Dues are not deductible as charitable contributions. As always, we suggest you consult your tax attorney or tax advisor for further details. This notice is pursuant to IRS Code Section 6113.

Please provide information for your company profile which will appear on the EPCOR Web site at www.epcor.org. EPCOR reserves the right to edit all information.
Company Name*
Contact Name*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area Code
Fax Number

Area Code
Email*
example@example.com
Web site URL (logo will link to this address)*
Upload Company Logo

Browse Files

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Description of services for your company profile which will be listed on the EPCOR Web site:*

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EPCOR Code of Conduct
EPCOR is a not-for-profit trade association responsible for providing payment systems education, support and industry leadership to its members. EPCOR has adopted a Code of Conduct to ensure that the activities that affect the payments industry are conducted with the highest levels of integrity, professionalism and fairness, and to ensure a mutually beneficial relationship.

This Code of Conduct identifies the standards of behavior expected of members of EPCOR and its various programs, and non-member organizations engaged in EPCOR’s activities and/or providing services to EPCOR or to members of EPCOR.

Membership in EPCOR commits members to comply with the standards of the EPCOR Code of Conduct. An organization and its representatives are in good standing under this Code if they:
1. Adhere to the spirit as well as the letter of all applicable regulations and laws, including antitrust, banking, privacy, and other relevant laws;
2. Avoid even the appearance of any criminal offense or professional misconduct;
3. Conduct business in a manner that does not adversely affect the payments industry;
4. Conduct all activities in a professional manner, thereby bringing credit to the payments profession;
5. Remain current with all financial obligations to EPCOR;
6. Comply with all applicable EPCOR policies and procedures; and
7. Work together to promote the efficiency, reliability, and security of the payments industry.
Title*
Financial Institution/Company Name*
Signature*

Clear
Both the EPCOR Membership Agreement and the EPCOR Code of Conduct must be completed, returned and payment must be received prior to activation of your EPCOR membership.

**EPCOR reserves the right to disassociate itself from any organization that, in EPCOR’s opinion, fails to abide by our Code of Conduct or otherwise brings discredit to EPCOR and/or the payments profession.
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Associate Member Application

EPCOR Code of Conduct