Become an Institutional/Organizational Member FacebookTwitterLinkedin Become an Institutional/Organizational Member Review benefits of institutional and organizational membership. Please enable JavaScript in your browser to complete this form.If you have any questions before completing this membership form or you are a company seeking to support our mission, please contact Todd Shelton, Executive Director. Organization/Institution Name *Contact Person *FirstLastLayoutPhone *Organization/Institution Logo Click or drag a file to this area to upload. If available, please upload your logo for inclusion on the HPN website. You can proceed with this form without the logo if it is not currently available.Email *Mailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSelect Membership Level Note: Pricing levels are the same for institutions and organizations. Membership LevelGold - $ 5,000.00Silver - $ 2,500.00Bronze - $ 1,500.00Make your payment If you prefer to pay by check, submit form without providing credit card information and mail check in the amount based on your membership level to: Hazing Prevention Network 11722 Allisonville Road, Ste 103, Box 355 Fishers IN 46038 Total$ 0.00Credit Card InformationCardName on CardSubmit