First Name

Last Name*

First Name Required Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Organization Name (Please do not abbreviate):* Organization Name (Please do not abbreviate) is Required

Job Title:* Job Title is Required

Member Email:* Member Email is Required

Phone Number:* Phone Number is Required

Do you work for / attend an institution with a collegiate recovery program?:* Do you work for / attend an institution with a collegiate recovery program? is Required

Yes In Development No I'm not sure

Type of Membership (Student): Type of Membership (Student) is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Select Payment Method

Credit Card Payment Via Check Payment Via Purchase Order Payment Via Grant

No val Please fix the errors above

Pay Association of Recovery in Higher Education: ARHE

$30 for 1 Year

Student – Payment

$30 for 1 Year

$30.00