Affiliate Application Form

Please complete all details below, then click Submit. Your application will be assessed and ACS will contact you with further information. Upon approval of your application you will have access to support and training to get started.

Acceptance of your application is subject to your general acceptance of the sentiment of the typical ACS Affiliate Agreement. The agreement is a starting point for negotiation. ACS is able to be flexible in some respects to fit your requirements, but the basic sentiment of the agreement would remain the same. Please review this agreement before applying.


I have read the Affiliate Agreement.

Personal Information

All fields in Bold are required

First Name:

Surname:

Title/Function:

Department:

Email:

to the ACS newsletter(please enter email first):

Direct Phone:

Company Information

Company Name:

Main Phone:

Main Fax:

City:

State:

Postcode:

Country:

Website:

Number of Sales Staff:

Number of Academic Staff: :

Annual revenue:

Markets sold to:

Years in Business:

Top 3 customers:

Professional Affiliations:

Current Quality Accreditations held:

Which courses are you interested in promoting?

Qualifications you wish to promote/license:

Current courses offered:

Further Information

Why do you wish to become an affiliate?

Why should ACS select you as an ideal affiliate?

Any additional information or comments

Ensure that you have filled in all the required fields in bold and have accepted the Affiliate agreement at the top of the page.

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