2014-15 Membership Contract and Invoice Your Institution * = required Institution * Select an Institution -- Not Listed (enter manually) -- Salve Regina University University of Dallas Villanova University Saint Joseph's University Duquesne University Gannon University Alvernia University Mount St. Joseph University Felician College University of Great Falls Saint Louis University University of St. Thomas (MN) Saint Mary's University of Minnesota University of Detroit Mercy Regis College (MA) Emmanuel College Boston College Anna Maria College Loyola University Maryland Saint Mary-of-the-Woods College Newman University University of Notre Dame Loyola University Chicago Regis University Marymount California University Dominican University of California Mount Mary University Marymount University (VA) University of St Thomas (TX) St. Mary's University (TX) Saint Vincent College Neumann University Mount Aloysius College Holy Family University Gwynedd Mercy University Franciscan University of Steubenville Ohio Dominican University Mount Carmel College of Nursing Notre Dame College St. John's University-New York The College of Saint Rose College of Mount Saint Vincent Le Moyne College Iona College Fordham University Saint Peter's University Caldwell University Creighton University Carroll College Fontbonne University Avila University St. Catherine University The College of Saint Scholastica College of Saint Benedict/Saint John's University Elms College Merrimack College Notre Dame of Maryland University Saint Joseph's College (IN) Holy Cross College Dominican University (IL) Lewis University DePaul University Chaminade University Saint Leo University Santa Clara University University of San Diego Mount Saint Mary's University (CA) Chestnut Hill College University of Portland Carlow University Xavier University (OH) Mercy College of Ohio Lourdes University University of Dayton St. Bonaventure University Niagara University Canisius College Georgian Court University Saint Anselm College Aquinas College Stonehill College College of the Holy Cross Mount St. Mary's University (MD) Thomas More College Bellarmine University Saint Mary's College (IN) Marian University (IN) Calumet College of Saint Joseph Thomas Aquinas College Saint Mary's College of California University of San Francisco Loyola Marymount University Spring Hill College Viterbo University Marquette University Seattle University Saint Martin's University Saint Michael's College Providence College Mercyhurst University St. Norbert College Marian University(WI) Gonzaga University Alverno College St. Edward's University University of the Incarnate Word Christian Brothers University Aquinas College (TN) University of Scranton Saint Francis University (PA) Rosemont College La Salle University La Roche College King's College Cabrini College DeSales University Walsh University John Carroll University University of Mary Belmont Abbey College Siena College Manhattan College Hilbert College Assumption College Xavier University of Louisiana Our Lady of the Lake College Loyola University New Orleans Saint Catharine College (KY) Benedictine College (KS) Barry University The Catholic University of America Sacred Heart University Fairfield University Albertus Magnus College Mount Saint Mary College (NY) St. John Fisher College St. Thomas Aquinas College (NY) Molloy College University of Saint Francis (IN) Benedictine University Mesa Newman University UK State * Select a 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Country * Select Country United States United Kingdom Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe I authorize the $1500 membership fee. * Yes, we will attend the 2014 Puerto Rico Catholic Colleges Recruitment Program and are submitting the $600 registration fee. Yes, we will attend the optional St. Thomas, US Virgin Islands visit day and are submitting the $132 airfare fee. Name of Representative Email of Representative Job Title of Representative 2014 Annual Catholic Colleges Reception Sponsorship Yes, we would like to be a sponsor for the 2014 Annual Catholic Colleges Reception during the Indianapolis NACAC conference. A National CCAA board member will follow up shortly with more details. Please check off at which level you would like to sponsor: $5000 Platinum Level $3000 Gold Level $1500 Silver level I would like to sponsor but I do not know at which level at this time. Please have a National CCAA board member follow up with me shortly. Name of Sponsorship Contact Email of Sponsorship Contact Job Title of Sponsorship Contact Please complete next fields to be included in our distribution list for National CCAA updates and to sign this contract. Primary Contact * Contact Name * Contact Title * Contact Email * Contact Phone Number * Second Contact Contact Name Contact Title Contact Email Contact Phone Number Third Contact (optional) Contact Name Contact Title Contact Email Contact Phone Number After you click "Submit Contract," you will receive an order confirmation if your contract was submitted successfully. DO NOT proceed with completing the credit card authorization form. You will receive an invoice in 5-7 business days. Inquiries Contact Contact Name Contact Title Contact Email Contact Phone Number This is a binding agreement to enroll as 2014-15 National CCAA members with website participation. Authorized by: Authorizing Contact * The authorizing contact is the same as the primary contact Contact Name * Contact Title * Contact Email * Contact Phone Number * Please note: After you click "Submit Contract" below, you will be redirected to the next page to enter in your credit card information. If you do not wish to pay by credit card, do not complete the next page, but simply click "Submit Contract" below and an invoice will be emailed to the primary contact in the next 2-3 days. Important: A Paypal account is not needed to submit credit card payment. The only requirement is a valid Visa or Mastercard. Membership dues to The National CCAA are non-refundable.