Organization Membership Application

Organization Membership Application
Org Random Id
Membership Type
Membership Option
Membership Option:
1 Period-${membershipOption}
Organization Name
Organization Information
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone
Format: (000) 000-0000.
Email
example@example.com
Geographic Footprint
Geographic Footprint
Mission
What sector(s) of the affordable housing and community development industry do you identify with? Please select all that apply.
Impact Data

We want to learn more about the great work that you and your team are doing! Please respond to the questions below about your organization's activities in 2022 (estimates are acceptable).
Approximately how many people are employed at your organization?
Approximately how many people did your organization serve within the last year?
What are the ethnicities of the people your organization served within the last year? (Select all that apply)
What is the gender distribution of the people your organization served within the last year? Example: ABC Company served 1,000 people last year. Of those 1,000 individuals, 50% identify as male, 40% as female, and 10% as non-binary. None of the individuals that ABC Company served chose to disclose their gender.
What is the age range of the people your organization served within the last year? Please select all that apply:
What types of populations does your organization serve? Please select all that apply:
Of the populations listed above, what is the primary population(s) your organization serves?
If applicable, how many units did your organization produce as a developer?
If applicable, how many properties did your organization produce?
Logo, Website & Social Media
Company Logo

Cancelof
Website
Twitter Profile URL
Facebook Profile URL
LinkedIn Profile URL
Office Manager/Accounts Payable Contact Information

Please provide contact information for the team member who handles invoicing
Title Office Manager / Accounts Payable
Name of Office Manager/Accounts Payable Contact

First NameLast Name
Preferred Phone # for Office Manager/Accounts Payable Contact
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Email for Office Manager/Accounts Payable Contact
President/CEO/Executive Director/Senior Executive Contact Information

Please provide the contact information for the most senior executive in your organization
Title President /CEO/Executive Director /Senior Executive
Name of President/ CEO/ Executive Director/ Senior Executive

First NameLast Name
Preferred Phone # for President/ CEO/ Executive Director/ Senior Executive
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Email for President/ CEO/ Executive Director/ Senior Executive
Primary Contact Information

Please provide the contact information for the main point of contact
Name of Main Point of Contact

First NameLast Name
Preferred Phone # for Main Point of Contact - Business
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Email for Main Point of Contact - Business
Please enter a valid Email.
Title
Would you like to make a donation to Housing& in addition to your membership dues? ($)
Why do you want to become a member of Housing&? Check all that apply.

Other
How did you hear about Housing&?
Please review the following information and check the box to indicate that you understand Housing&'s membership billing.
Please review the following information and check the box to indicate that you understand the process of cancelling membership

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Organization Membership Application

Organization Information

Impact Data

Logo, Website & Social Media

Office Manager/Accounts Payable Contact Information

President/CEO/Executive Director/Senior Executive Contact Information

Primary Contact Information

Total*

Total