Why join the Action Alliance
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Virginia's leading voice on sexual and intimate partner violence.
Because everyone deserves to live a life free of violence.
Membership Application
Name
Agency (if applicable)
Mailing Address
City State Zip
Work phone Home phone
E-mail
Yes! I want to join the Action Alliance at the following membership level...
For a full description of membership benefits, visit . Dues listed are annual, and may be reduced or waived upon request. All memberships are for the calendar year and renewals are sent at the end of each year, with the exception of Lifetime Memberships which do not require any further dues payment once the Lifetime Membership Contribution is paid in full.
❑ Basic Membership: $25
❑ Professional Membership: $50
❑ Lifetime Membership: $1,000 (not annual)
❑ Affiliate Membership (for agencies, organizations, businesses and units of state/local government that support the mission of the Action Alliance) : $350
❑ Sexual and Domestic Violence Advocacy Membership (for non-pforit agencies and units of local government, colleges, universities, and military institutions whose primary function 75% or more of time and resources) is sexual/domestic violence or prevention work. Dues based on number of staff)
❑ Fewer than 3 FTEs: $1,500
❑ 10-19 FTEs: $2,000
❑ 20 or more FTEs: $3,000
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Please make checks payable to Action Alliance. Send your completed form & check to:
Action Alliance
1118 W. Main Street
Richmond, VA 23220
Action Alliance ( ( 804.377.0335 ( info@
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