Application for Affiliation

Application for Affiliation
Organization Information
Today's Date*

MonthDayYear
Name of Organization*
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone*
Please enter a valid Phone Number
Website
Primary Email*
example@example.com
other Email
example@example.com
Organization Head information
Organization head title*

PresidentChairOther (please specify below)
If Organization head title is "Other" please specify here
Name*

First NameLast Name
Organization head Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Email*
example@example.com
Organization Publicity Chair
Name

First NameLast Name
Phone
Email
example@example.com
Organization Newsletter Editor
Name*

First NameLast Name
Phone*
Email*
example@example.com
Organization Questions
Number of members in organization*
Upon affiliation FFN will need your membership list
Founding date of the organization*
Average number of meetings annually*
When do you hold officer elections?*
Number of Print newsletters annually*
Number of E-news newsletters annually*
Does your organization have a written history?*

YesNo
Is your organization incorporated?*

YesNo
Is your organization tax-exempt?*

YesNo
Do you have liability insurance?*

YesNo
Does your organization underwrite scholarships?*

YesNo
Does your organization have a scholarship committee?*

YesNo
List the most important regular cultural and educational activities that your organization sponsors each year for its members and/or the general public*
Questions, comments
Your Name*

First NameLast Name
Title*
Signature*

Clear
Date*

MonthDayYear
Should be Empty:

Application for Affiliation

Organization Information

Organization Head information

Organization Publicity Chair

Organization Newsletter Editor

Organization Questions