Alliance Membership Registration Form

We’re thrilled to welcome you as a new member of The Alliance!

Just a reminder of your benefits as a dues-paying member:

Networking with other human services leaders
The opportunity to run for a board seat electing the Board of Directors
Participate on an Alliance Committees
Co-sponsor Alliance events
Discounts on Alliance select event registration fees
Early bird access to registration for Alliance events
Marketing support to amplify YOUR organization and YOUR events
Strategic organizational support
So much more!

Annual membership is valid for 12 months from the time payment is received. Five-year memberships are valid for 5 full years from the date payment is received.

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* Organization/Individual/Family Name

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* Point of contact for this membership:

Contact Person's Name

Contact Person's Address

Contact Person's Email Address

Contact Person's Phone Number

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* Please indicate how you'd like to pay for your membership.

Online via credit card or debit card (Please use the prompt at the end of this registration form)

Check or Money Order (Please make payable to "The Alliance" at 9071 Center Street, Manassas VA 20110)

Invoice (Request follow-up)

ACH (Request follow-up)

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* To pay online, please confirm your membership below and complete payment using the secure Stripe portal on the next page.

Individual/Family - One Year - Regular Member - $100 - $50 USD

Individual/Family - Five Years - Regular Member - $500 - $0 USD

Organization - One Year - Regular Member - $100 - $100 USD

Organization - Five Years - Regular Member - $500 - $0 USD

You’ll enter payment info after the survey.