Gift of Membership Campaign

Want to support someone or a group of individuals as they find their professional home at ACPA-College Student Educators International? The Gift of Membership allows you do just that!

INSTRUCTIONS:

1. Please fill out your and the recipient(s) information in the spaces provided below.
2. If you are buying memberships for more than person, then be sure to make that note in the drop down box and provide all the recipient's names. You may submit up to 5 names total!
3. When payment is received, we will send a note to the recipient confirming their Gift of Membership and and next steps on how to take advantage of their ACPA membership!

	College/University Member	Non College/University Member
Full-Time Professional/Faculty	$99	$179
Doctoral Student	$49
Masters Student	$39
Undergraduate Student	$12
Transitional	$39.99
Membership + Printed copies of JCSD & About Campus:	$21

Date*

MonthDayYear

Your Full Name*

First NameLast Name

Institution/Organization

Your E-mail Address*

Phone Number

How many other memberships are you gifting?

Recipient Full Name*

First NameLast Name

Recipient Member Type *

Recipient Institution/Organization

Recipient E-mail Address*

Recipient Phone Number

Recipient Full Name - 2*

First NameLast Name

Recipient Member Type - 2*

Recipient Institution/Organization - 2

Recipient E-mail Address - 2*

Recipient Phone Number - 2

Recipient Full Name - 3

First NameLast Name

Recipient Member Type - 3 *

Recipient Institution/Organization - 3

Recipient E-mail Address - 3

Recipient Phone Number - 3

Recipient Full Name - 4

First NameLast Name

Recipient Member Type - 4 *

Recipient Institution/Organization - 4

Recipient E-mail Address - 4

Recipient Phone Number - 4

Recipient Full Name - 5

First NameLast Name

Recipient Member Type - 5 *

Recipient Institution/Organization - 5

Recipient E-mail Address - 5

Recipient Phone Number - 5

GIFT OF MEMBERSHIP

Purchaser Information

Recipient Information

Membership Gift

Billing Information