Organization Name:

Address:

Address 2:

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

E-mail:

Website:
(e.g., http://www.google.com)

Phone:

Fax:

Username:

Password:

Primary Contact Name:

Primary Contact Position:

Primary Contact E-mail:

Primary Contact Phone:

Secondary Contact Name:

Secondary Contact Position:

Secondary Contact E-mail:

Secondary Contact Phone:

Student Group Advisor Name:

Student Group Advisor E-mail:

Student Group Advisor Phone:

YES! I certify that I am an authorized representative of my organization and that my organization would like to become a member of Student Veterans of America (SVA).

YES! I am aware of and fully understand the membership eligibility requirements for SVA and find that my organization is eligible for membership in SVA.

YES! I further attest that my organization is officially recognized as a student organization at an institution of higher education.

YES! I attest that my organization’s primary mission is aimed at the general welfare of student-veterans who are enrolled or intend on enrolling at the institution of higher education.

YES! I give authority to SVA to verify my organization’s eligibility for membership.

YES! I understand that it is a condition of approval of this application for membership that I fully know and understand all responsibilities of membership in SVA, as expressed or implied in the SVA Constitution and other applicable documents. Violation of any of those responsibilities by my organization or any member of my organization is grounds for revocation of membership in SVA.