SVU Signature School Membership Application

Invoice Date(Required)
Address of Institution/School:(Required)

Discounted Student Rate: $25 per person Liaison

Discount: $10 off membership (primary liaison only)

  1. Please complete this form below. To receive the discount, 100% student participation is required.
  2. Please submit an individual Contact Form for each new and renewing member.
  3. Please list the names and graduation dates of your SVU Signature School members below:
SVU Signature School Members
Name
New Member (Y/N)
Renewing (Y/N)
Graduation Date (MM/DD/YYYY)
Member #*
 
*For new members leave the member # blank.
Please enter a number greater than or equal to 1.
$25 per student member
Please enter a number greater than or equal to 1.
155 for 1st faculty member & $165 for additional members
Student Dues + Faculty Dues
Choose a Payment Method(Required)
If credit card is selected and none is saved on file, an invoice will be sent instead. Please note all applications will be charged together under one payment (ie. One credit card or check for the amount above).