League Alliance Online Enrollment Form

League Alliance Membership is $500 per year for educational institutions. Each separately accredited college in a multicollege district must have its own membership. Then membership year is July 1-June 30.
Colleges may enroll at any time. 

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Chief Executive Officer
(Executive League Alliance Contact)
Name
Title
Institution
Address1
Address2
City
State/Province
Zip
Country 
(if not U.S.A.)
Phone
Fax 
Email
 
Alliance Representative
(League Alliance contact for distribution of publications and membership resources)
Name
Title
Please fill out the address information below if it is different from the institutional address.
Institution
Address1
Address2
City
State/Province
Zip
Country 
(if not U.S.A.)
Phone
Fax 
E-mail
 

Staff Development Officer
 (League Alliance contact for staff development resources)
Name
Title
Please fill out the address information below if it is different from the institutional address.
Institution
Address1
Address2
City
State/Province
Zip
Country 
(if not U.S.A.)
Phone
Fax 
E-mail
 
Payment Information
Institutional Alliance membership is $500. The membership year is July 1-June 30, and colleges may enroll at any time.
 
Payment Method
 
Please Invoice my institution
Purchase Order Number #
 
Credit Card #
Expiration Date:
Name on card:

Please check this form thoroughly before submitting.
   Have you:
      - Filled in all your contact information?
      - Provided essential payment information?
Once the form is complete, click the submit button to send your membership application.

For additional League Alliance information contact:
Gerardo de los Santos
Vice President for Alliance Services
Phone: 949-367-2884 Ext. 121