The Tier 5 Agency Membership allows an agency to purchase 30 memberships that belong to the agency. The purchaser can award the memberships either by entering in each person’s information for each slot or by sharing the unique link provided after purchasing directly to each staff member. The purchaser is able to manage each individual membership within their tier.

Agency memberships are recurring so the credit card will automatically be charged after 1 year for renewal. Renewal reminder email notifications will be sent out 30 days, 7 days, and 1 day ahead.

Name:*

First Name

Last Name*

First Name Required Last Name Required

Billing Address

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

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State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Preferred Name: Preferred Name is not valid

Middle Initial: Middle Initial is not valid

Daytime Phone Number: Daytime Phone Number is not valid

Agency or Organization Name:* Agency or Organization Name is Required

Role/Job Title:* Role/Job Title is Required

Home Address City:* Home Address City is Required

Home Address State:* Home Address State is Required

Area of Advocacy:* Area of Advocacy is Required

System-based AdvocacyCommunity-based AdvocacyDefensa militar Defensa del campusOther

Pronouns: Pronouns is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Select Payment Method

Pay by Credit or Debit Card Pay By Check

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When paying by check, the name, email address, and username of the account must be included and sent to: NOVA, Attn: Membership 510 King St Suite 220 Alexandria, VA, 22314 Memberships that are paid by check are not active until a NOVA staff member successfully processes your payment. You will not be able to access any member content or benefits until your payment is received and processed.

 

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$2,400 / Year

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Terms: $2,400 / Year

 

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  Tier 5 Agency Membership (Up to 30 Staff) – Initial Payment

  $2,400 / Year

  $2,400.00

Total

$2,400.00