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NONPROFIT LEADERSHIP MEMBERSHIP APPLICATIONDLM Coalition of Hispanic Nonprofits of North Texas

The Coalition is a regional leadership forum connecting Hispanic-serving and community-based nonprofit organizations across North Texas for collaboration, strategic alignment, funding visibility, and collective impact.Membership is complimentary and lifetime. Organizations will receive an annual information update request to maintain accurate directory and regional data records.
Date*

MonthDayYear
Date
Organization Name*
Primary Representtive Name*

First NameLast Name
Nonprofit Membership includes one designated Leadership Representative who serves as the organization’s primary Coalition contact and receives Individual Leadership Membership within the Coalition. Additional affiliated leaders may apply separately if desired.
Job title:*
EX: Executive Director
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Office Number*
Cellular Number*
Direct Number
Address*
Website*
Add Additional Members

Please List up to Four additional Individual Members. Please enter their Full Name, Email address and Phone Number.
1. Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
2. Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
3. Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
4. Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
IRS Tax-Exempt Classification(Please indicate your organization’s current IRS designation. Examples: 501(c)(3) Public Charity, 501(c)(4), 501(c)(6), Religious Organization, Government Entity, Other.)*
Funding Eligibility Notice:
At this time, only IRS-recognized 501(c)(3) public charities in good standing are eligible to receive Coalition-administered funding. Other nonprofit classifications are welcome to join but are not eligible for direct funding.
EIN#*
By submitting this application, you authorize the Coalition to verify your organization’s tax-exempt status through the IRS Tax Exempt Organization Search.
Annual Budget Range*

below $50,000above $150,000above $250,000above $500,000
Geographic Area Served*
Organizational Needs
Topics you are interested in learning about:
In 2–3 sentences, describe your organization’s primary impact focus.*
Are you interested in serving on a committee?*

YesNoNot at this time
Are you interested in assisting with planning events?*

YesNoNot at this time
Please Share your Organization Logo

Cancelof
By becoming a member of the DLM Coalition of Hispanic Nonprofits of North Texas, you grant permission for the Coalition to share your organization’s name, logo, and general program information through its website, newsletters, reports, and social media platforms for promotional and collaborative purposes.*

YesNo
Submission of this application does not guarantee membership approval. The Coalition reserves the right to review applications to ensure alignment with its mission and collaborative values. Member organizations must remain in good standing with the IRS.*

Clear
Signature Date*

MonthDayYear
Date
Should be Empty:

NONPROFIT LEADERSHIP MEMBERSHIP APPLICATIONDLM Coalition of Hispanic Nonprofits of North Texas

Add Additional Members