Membership Form

Please complete the following information regarding 23-24 CIAVA membership. Once you click "Submit", you will be re-directed to the dues payment page. Please note your membership will not be complete until payment is received.

23-24 Membership Dues

Standard Membership | Regular Dues: $150
Associate Membership | Dues: $120

For Students, Retirees, Active AmeriCorps Members, and Administrators who are currently between jobs

Organizational Membership | Dues: $300

Benefits can be shared by up to two staff of the same organization. Additional staff can be added at any time at Assoc. Member price.

Member Information

* Indicates required field

Name *

First

Last

Title *

Organization Name *

Do you have your CVA? *

Contact Information

Email *

Preferred Phone *

Membership Type & Payment

Type *

How will you pay dues? *

For Associate Membership

(Skip if applying for any other membership.)

Please select your qualifying status: *

For organizational Membership

(Skip if applying for any other membership.)

Please list the names, titles, and email addresses of all other staff members using the CIAVA benefits. *

release

This Release ("Release") is executed in favor of Central Indiana Association of Volunteer Administration and each and all of its directors, officers, agents, and representatives (collectively, "CIAVA"). I hereby freely and voluntarily execute this Release and agree to the following terms and conditions as a member of the association:

MEDIA RELEASE: I grant CIAVA permission to use my name, image, voice, appearance, and likeness for stories or advertisements that may be solicited on its behalf. This may include, but is not limited to, print advertising, photographs, public service announcements, promotional materials, video or audio recordings, news reports, etc. I understand I will not be eligible for any compensation related to the production and use of my name, image, voice, appearance, or likeness in any advertising or promotional materials and other media coverage as set forth herein.

By clicking the submit button below labeled you:

(1) Acknowledge that you have read and understand the Terms detailed above;
(2) Acknowledge that your membership status will remain inactive until payment is received in full;
(3) Are signing this agreement using your electronic signature.
Under federal law, an electronic signature like this one is just as binding as manually signing a paper document.

Submit