Gift of Membership Campaign

GIFT OF MEMBERSHIP

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 recieved, 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	$89
Membership + Printed copies of JCSD & About Campus:	$21

Date *

Month Day Year Date Picker Icon
Purchaser Information
Your Full Name *

First Name Last Name
Institution/Organization
Your E-mail Address *
Phone Number
How many other memberships are you gifting?

1 2 3 4 5
Recipient Information
Recipient Full Name *

First Name Last Name
Recipient Member Type *
Recipient Institution/Organization
Recipient E-mail Address *
Recipient Phone Number
Recipient Full Name - 2 *

First Name Last Name
Recipient Member Type - 2 *
Recipient Institution/Organization - 2
Recipient E-mail Address - 2 *
Recipient Phone Number - 2
Recipient Full Name - 3

First Name Last Name
Recipient Member Type - 3 *
Recipient Institution/Organization - 3
Recipient E-mail Address - 3
Recipient Phone Number - 3
Recipient Full Name - 4

First Name Last Name
Recipient Member Type - 4 *
Recipient Institution/Organization - 4
Recipient E-mail Address - 4
Recipient Phone Number - 4
Recipient Full Name - 5

First Name Last Name
Recipient Member Type - 5 *
Recipient Institution/Organization - 5
Recipient E-mail Address - 5
Recipient Phone Number - 5

Membership Gift
How would you like to pay? *

Send an invoice to pay by check Pay now by credit card
Billing Information
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email *
example@example.com
Phone Number

Area Code Phone Number

My Products *

Full-Time Professional/Faculty - College/University Member: $ 99.00

Quantity

Full-Time Professional/Faculty - College/University Member + Printed copies of JCSD & About Campus: $ 120.00

Quantity

Full-Time Professional/Faculty - Non College/University Member: $ 179.00

Quantity

Full-Time Professional/Faculty - Non College/University Member + Printed copies of JCSD & About Campus: $ 200.00

Quantity

Graduate Student-Doctoral: $ 49.00

Quantity

Graduate Student-Doctoral + Printed copies of JCSD & About Campus: $ 70.00

Quantity

Graduate Student-Masters: $ 39.00

Quantity

Graduate Student-Masters + Printed copies of JCSD & About Campus: $ 60.00

Quantity

Undergraduate Student: $ 12.00

Quantity

Undergraduate Student + Printed copies of JCSD & About Campus: $ 33.00

Quantity

Transitional: $ 89.00

Quantity

Transitional + Printed copies of JCSD & About Campus: $ 110.00

Quantity

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty:

GIFT OF MEMBERSHIP

Purchaser Information

Recipient Information

Membership Gift

Billing Information