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Please indicate payment method for US$335. ❑ Compliance & Ethics ❑ International Legal Affairs ❑ Corporate & Securities Law ❑ Intellectual Property ❑ Employment & Labor ❑ Law Department Management ❑ Energy ❑ Litigation ❑ Environmental & Sustainability ❑ New to In-house ❑ Transfer to: PNC Bank 800 17th Street NW, 3rd Floor Washington, DC 20006 USA SWIFT Code: PNCCUS33 | Routing/ABA Number: 031000053 Account Title: Association of Corporate Counsel Account Number: 5303564367 ❑ Financial Services ❑ Nonprofit Organizations ❑ Health Law ❑ Real Estate Law ❑ IT, Privacy & eCommerce ❑ Small Law Departments ❑ Insurance Staff Counsel ❑ Sports & Entertainment 07/2014 Charge my: ❑ VISA ❑ Mastercard ❑ AMEX ❑ Discover Account number Exp. Date (MMYY) Printed name Signature You will receive documents from ACC in English. By in-house counsel, for in-house counsel.® Targeted Practice Information Please complete the following questionnaire so that we can send you targeted practice information relevant to your career stage. NUMBER OF YEARS WORKING AS IN-HOUSE COUNSEL ❑ 1–2 years ❑ 3–5 years ❑ 6–10 years ❑ 11–15 years ❑ 16–20 years ❑ 21 + years TITLE WHICH BEST DESCRIBES YOUR POSITION ❑ Chief Legal Officer/General Counsel ❑ Division Counsel ❑ Deputy General Counsel ❑ Assistant/Associate General Counsel – Supervisory ❑ Assistant/Associate General Counsel – Non-supervisory ❑ Managing Lawyer (New) ❑ Managing Lawyer (3+ years) ❑ Senior Lawyer ❑ Staff Lawyer ❑ Other PRIMARY PRACTICE AREA ❑ Commercial Law ❑ Financial Services ❑ Litigation ❑ Compliance & Ethics ❑ Government ❑ Media/Publishing ❑ Corporate, Securities & Governance ❑ Insurance ❑ Real Estate ❑ Employment & Labor ❑ Intellectual Property ❑ Technology ❑ Energy/Public Utility ❑ International ❑ Environmental Law ❑ Law Department Administration INDUSTRY ❑ Accommodation and Food Services ❑ Health Care & Social Assistance ❑ Public Administration ❑ Administrative and Support & Waste Management and Remediation Services ❑ Information Technology ❑ Real Estate Rental and Leasing ❑ Management of Companies & Enterprises ❑ Retail Trade ❑ Manufacturing ❑ Transportation and Warehousing ❑ Agriculture, Forestry, Fishing & Hunting ❑ Arts, Entertainment & Recreation ❑ Construction ❑ Mining ❑ Educational Services ❑ Non-Profit, Industry Group or Trade Association ❑ Energy, Oil & Gas ❑ Pharmaceuticals ❑ Finance, Banking or Insurance ❑ Professional, Scientific & Technical Services ❑ Telecommunications ❑ University/Academia ❑ Utilities ❑ Wholesale Trade ❑ Other NUMBER OF LAWYERS IN YOUR LEGAL DEPARTMENT (including yourself & all counsel at all locations) ❑ 1 ❑ 2–5 ❑ 6–10 ❑ 11–20 ❑ 21–50 ❑ 51+ MY COMPANY IS ❑ Public ❑ Private ❑ Non-profit MY COMPANY OPERATES IN ❑ Asia Pacific ❑ Canada ❑ Europe ❑ Latin America ❑ Middle East and North Africa ❑ Sub-Saharan Africa ❑ USA