ACA MEMBERSHIP FORM
      This is a form to request or renew your ACA membership.

      As a member of ACA you will receive regular electronic mailings of the "News Update" 
      (published ten times a year) which contains important information on legislation and 
      issues affecting US citizens living overseas.  You will also news about ACA's work 
      throughout the year; ACA's attendance at the Washington DC "Overseas Americans Week,"
      ACA collaboration with PEW and OVF (on voting issues), ACA's interface and dialog with 
      the Americans Abroad Caucus addressing issues such as: tax equalization, voting, 
      Medicare and Social Security benefits, and overseas banking issues.

      ACA guarantees that your name and address will be held in strictest confidence.

      If you want to bypass this form and pay directly through PayPal®, click here

      To print this form as a pdf file on your computer, click here

      ACA  5 rue Liotard  1202 Geneva  Switzerland

      To join ACA, please fill out the boxes below.

New or renewal of membership?
                   New Member     Renewal

        Choose one: 
                   Individual Member  US$60.00 (or CHF 60)
                   Senior Member (age 60 or older)  US$45.00 (or CHF 45)
                   Contributing Member  US$150.00 (or CHF 150) 
                   Life Member  US$525.00  (or CHF 525)
                   Corporate Sponsor  US$750.00 (or CHF 750)


      Family Name:  (Must be entered)
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             City:  
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          Country:   
            Phone:  Fax:  
    Email address:  (Must be entered)
          Remarks: 
                   
ACA guarantees that your name and address will be held in strictest confidence.  
Your email address will be used only for acknowledging membership and 
sending news from ACA as per your request. 
 
Choose your payment method:
 
               By separate bank transfer to 
               UBS SA 
               Case postale
               1211 Geneva 2 
               Switzerland      BIC/Swift: UBSWCHZH12A
                   Bank transfer in US$ IBAN: CH74 0024 0240 2008 0660 P
                   Bank transfer in CHF IBAN: CH30 0024 0240 2008 0600 R  
                  
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                    Expiry date:  Name on card: 



          Please enter the answer to the following arithmetic problem:
          What is 23 minus 14 ?   (anti-spam test, must be entered)
          

If you have trouble sending this form via the internet, phone or fax our Geneva office: +41 22 3400233.
or print as PDF and send to: ACA  5 rue Liotard  1202 Geneva  Switzerland or by email .
If you want to pay using PayPal^®, click here