Indiana Coalition Against Domestic Violence and the Resource Center
 

ICADV Membership Application Form

There are several ways to join the ICADV.

ONLINE APPLICATION AND PAYMENT

To become a member of the ICADV please fill out the following On-Line Membership Application Form and use your credit card to make the corresponding donation using the PayPal system. PayPal is a safe and secure transaction provider. To join on-line click here.

MAIL IN YOUR APPLICATION AND PAYMENT

Alternately you can join the ICADV by filling out our hard copy Membership Application Form (click here for an Adobe Acrobat file, or here for a Microsoft Word Document) and mailing it, with your check or money order to:

Indiana Coalition Against Domestic Violence
Attn: Linda Olvey
1915 W. 18th Street, Suite B
Indianapolis, IN 46202

APPLY BY PHONE AND PAY USING YOUR CREDIT CARD

Simply call us at (317) 917-3685 or (800) 538-3393 and we'll fill out your membership application over the phone.

MEMBERSHIP LEVELS

For details on the benefits of each level of ICADV membership, please see our Membership Benefits page. ICADV membership levels are listed below:

Personal ($50)
(Students and Seniors receive a 50% discount on Personal Membership)

Partner ($150)

Provider ($500)
ICADV Provider Members provide direct prevention intervention and advocacy services to either victims or offenders of domestic violence.

Patron ($501and above)

ON-LINE MEMBERSHIP APPLICATION FORM

Fill out the form below. All fields except "Organization" are required. When done, click the "Send Information" button. Then click on the PayPal button. This will open a PayPal payment page. Use your credit card to make your payment using PayPal.

Your Name or Contact Person

Street

City

State

Zip

Phone

Email

Organization Name

Membership Level

    

Home | About Us | Resources and Programs | You Can Help | Site Index

Information on this site copyright 2000 and later by the Indiana Coalition Against Domestic Violence.
Please email questions regarding use of this copyrighted material.
For information on this website, or to report broken links please email web-admin.

Indiana Coalition Against Domestic Violence
1915 W. 18th Street Indianapolis, IN 46202
Phone (317) 917-3685 or (800) 538-3393
Fax (317) 917-3695
Crisis Line 1-800-332-7385