NIRSA Mailing List Request Form
You must complete all fields of this form in order to have your application processed.
Sign in to Google to save your progress. Learn more
NIRSA Mailing List Usage Policy
NIRSA Associate members and non-members may purchase NIRSA’s membership lists on a one-time-use only basis.  Materials cannot specifically reference any affiliation or connection with NIRSA without receiving express written permission from NIRSA.  Orders cannot be finalized without the submission and approval of proposed mailing material. NIRSA does not sell email addresses.
Please email Emily.Hughes@nirsa.org with questions.
Process
1) Complete this NIRSA Mailing Address Request Form.  

2) Submit an electronic sample (flyer, announcement, etc.) of the mailing to Emily.Hughes@nirsa.org. NIRSA must approve all materials being sent prior to the mailing list being fulfilled.

3) Invoice is sent for project approval. Invoice will be sent within 48 business hours of request submission.

4) Submit complete payment.  NIRSA accepts all major credit cards, checks & EFT.

5) Mailing list requests will be fulfilled immediately following receipt of payment. One-time use lists are delivered electronically in Excel format.
Your name: *
Company/Organization: *
Email address: *
Daytime Phone:
Target Audience:
Member Type: *
Required
Required
Functional Titles Requested: *
Required
Job Responsibilities Requested: *
Required
Select your membership pricing *
What is your current member status?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of NIRSA. Report Abuse