Donation Form

Independent Workers Alliance has three forms of membership:

Tier 1: Silver Members

Free membership (no dues)
Monthly social networking events
Free job training
Access to job referral database
Affiliate business discount card (receive 10 to 30 percent off participating businesses services & products)

Tier 2: Gold Members

Ten dollar monthly dues
Monthly job growth seminars
Private job search & referral service
Volunteer 16 Hours monthly
IWA Gold member discount card (receive 30 to 50 percent off participating businesses services & products)

Tier 3: Platinum Members

Forty dollar monthly dues
16 Hour monthly volunteer
Job growth seminars
Private job search & referral service
Group discount health insurance programs
Career counseling
Credit repair & upkeep
Private car sales & financing
After six months being an active member (one week vacation w/ participating employers)
After six months being an active member (two paid personal days w/ participating employers)

Contact Information

First Name

Last Name

Profession

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Employer

Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $0.00 to go to Independent Workers Alliance and I will donate $0.00.No. I will donate $0.00 and Independent Workers Alliance will cover the processing costs.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.