AFFILIATEMEMBERSHIP

Description of Business: Describe the nature of the applicant’s business:

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Number of Employees:

If elected to membership, the applicant accepts and agrees to adhere to ACC Bylaws and will pay an annual fee for Affiliate membership and its associated privileges.(Please initial)

Purpose for Joining: Describe the reason for seeking ACC Affiliate membership:

Environmental, Health, Safety & Security (EHS&S) Management Program Your Company Adheres to: (e.g. Responsible Care®; Responsible Distribution; ISO 14001; OHSAS 18001; Responsible Carrier; Coatings Care; Chemical Distribution Institute; Responsible Ag; LCA SAFE). If your company does not participate in a specific program, please describe your company’s approach to managing EHS&S issues.

Please return your completed application to:Ashley Musselman, Manager, Business DevelopmentAmerican Chemistry CouncilAshely_Musselman@americanchemistry.com202-249-6113700 2nd Street, NEWashington, DC 20002

APPLICATION FOR AFFILIATE MEMBERSHIP

Applicant Information:Company NameName of Primary ContactPrimary Contact’s Telephone NumberEmail AddressAddressCity State ZipCompany URL Address

If selected as an ACC Affiliate member, the senior-most representative of the company interacting with ACC on significant issues should be the Executive Contact. For most members, this would be the President & CEO, or equivalent leader for the company’s chemical business.Executive Contact’s Name TitleEmail Address

ACC AFFILIATE MEMBERSHIPACC’s mission is to deliver business value through exceptional advocacy. Our goal is to foster a regulatory and marketplace environment that allows our members to innovate, expand, and efficiently create the products that respond to consumer demand and generate value to shareholders. A healthy manufacturing base means a robust value chain and an increased need for service suppliers such as sales and marketing; logistics and distribution; storage and disposal, and everything in between.

BENEFITSAs an Affiliate member, you become part of the leading voice of the chemical industry and a collaborative partner as we navigate the business, regulatory, and political climate. The value, benefits, and opportunities that membership offers provide an immediate return on investment:

Business growth and networking opportunitiesEngage with industry leaders at the many ACC meetings and conferences, including:

• ACC’s Annual Meeting (Open only to Regular, Affiliate, and Chairman’s Level Associate members, as well as event sponsors.)

• GlobalChem• Responsible Care® Conference/Workshops

• ACC Chairman’s DinnerEnhanced stakeholder relationships throughout the value chainmeetings and conferences, including:

Effective advocacy

• Integrated advocacy programs on a state, federal, and regulatory level

• Best-in-class political mobilization, communications and litigation services

• Leadership on priority initiatives including chemical management, energy, EH&S, security, tax, & rail, among others

Economic industry intelligence and research• Business & Information Networks• Weekly Economics Report• Monthly Global Production Index • Bi-Annual Situation and Outlook • Guide to the Business of Chemistry

Enhanced visibility and reputation management• Company listing in ACC Membership Directory• Link to corporate website from ACC’s public

website• Recognition in new member press release

Advocacy and Engagement Opportunities

In addition to information, visibility and networking, Affiliate members are given exclusive opportunities to work with ACC and our members through our Political Mobilization program, and through partnerships on webinars and workshops on key issues such as transportation, safety, energy, and more.

ACC’s Affiliate members comprise the chemical industry’s value chain partners. Affiliate members are typically engaged in one of the following services:

Affiliate Member Logo

“Affiliate Member of ACC” logo for use on corporate website and promotional materials.

Chemical Distribution

Construction

Equipment

Hazardous Waste

Logistics

Plastics Products

Raw materials

Warehousing & Storage

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ELIGIBILITY