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ACCT MEMBERSHIP RENEWAL
member information
- membership type - confirmation - payment
*Please note that you cannot change your membership designation using this form.
If you wish to change your membership type, you must contact our Membership Department.
* Please fill out all required fields
Name *
Both first and last name
You must enter your name.
Membership Number *
Enter your member ID as listed on your invoice.
Please enter your member ID number.
Date to Renew
Enter the "date due" as listed on your invoice.
Select
January
February
March
April
May
June
July
August
September
October
November
December
Email *
We won't share your email address!
You must enter a valid email address.
Address *
Address from your invoice
You must enter your address listed on your invoice.
City *
If USA/ International, please add state/country
You must enter your city.
Province *
Current home province
Select
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
USA
INT
Postal Code *
Current home postal or zip code
You must enter a valid postal code or zip code.
Telephone *
Home phone
Please enter a valid phone number.
Additional Notes
Any other changes you want us to know about
Discount Code
Enter your special discount code
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Academy of Canadian Cinema & Television
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