Membership Application
*College/University:
*Name of your Alternative Break Program:

Your Program Mailing Address		  
*Street Address:
*City, *State *Zip:
Program Web Page:

Individual Contact Info		  
*Staff Contact Name: *first: *last:
*Department:
*Title:
*Phone Number:
Fax Number:
*Email:

*Student Contact Name:
*first: *last:
*Title/Position in Alternative Break Program:
*Phone Number:
Fax Number:
*Email:

Who would you like to be on the members' e-mail listserv? Staff Student Both

Which membership level would you like to purchase? Host Site Membership ($100) Associate ($250) Advantage ($650)

Membership Add Text

All Break Away® Chapter Schools are recognized for their commitment to quality alternative break programs. Advantage Members receive the greatest value, including free registration to our national training session and priority access to any grants or partnerships. As you choose the level of membership that best fits the needs of your program, remember that Break Away currently provides the following benefits to both levels of Chapter School Members:

  • Local and National Media Referrals, sources in the past include the Washington Post, USA Today, Wall Street Journal, Christian Science Monitor and CNN.com
  • Access to the SiteBank, Trip Report Database, Members Email listserv, and Sample Documents
  • Exclusive use of the Break Away name and logo to identify your school as part of the national alternative break movement
  • The Chapter Manual, a comprehensive "how to" guide for alternative break planning
  • Associate Members receive a 10% discount on all Break Away products and services, including Site Leader Retreats and ABCs Registration fees
  • Advantage Members receive a 20% discount on all products and services plus a free registration to the 2010 ABCs (a $700 value)


(You will be redirected to PayPal to complete this purchase)
 
Break Away | 2451 Cumberland Pkwy | Suite 3124 |Atlanta, GA 30339
Toll Free 800/903-0646 | Email breakaway@alternativebreaks.org
Design by Eric Donaldson
Programming by Kevin Krzyzanski
Original Design/Database by Yosh Schulman