The Alliance for a Hunger Free New York Membership Application

The Alliance for a Hunger Free New York Membership Application
Thank you for your interest in joining The Alliance for a Hunger Free New York. Please complete the following application, and someone from The Alliance Staff will review it and reach out to you.

This application is comprehensive; please fill it out as much as you can - you will be able to save it and return to it if need be.

If you struggle or have any questions about the application, please schedule a time to meet with The Alliance Manager, Peyton, by using this link.

Please also see the membership guidelines here for your reference.

What's the difference between a member and an affiliate member?

See more in the membership guidelines here.

Members:
- Must be a 501c3 Frontline Emergency Food Provider
- Is eligible for potential funding opportunities
- Has ability to vote as determined
Affiliate Members:
- Organizations and individuals that are interested in ending hunger
Are you applying to be a Member or an Affiliate Member?

MemberAffiliate Member

Organizational Contact Information
This information will be public on our list of members and on our Food Connect Map and Database
Organization or Program Name:*
Physical Address of program(s) and/or service(s):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Same as my mailing address?

YesNo
Mailing Address (if different):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Office Phone
Please enter a valid phone number.
Please describe your days and hours of service(s):*
Which county(s) do you serve?
Select all that apply
Which county(s) do you serve?

Individual Contact Information
Name

First NameLast Name
Pronouns
Title
Email
example@example.com
Phone Number
Please enter a valid phone number.
Leadership Contact Information

(If different)
Name

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

What is your policy on the number of times a family/individual can use your program(s) and/or service(s)?
What documentation (if any) do you require from guests?

Driver's License or IDBenefits CardTEFAP AttestationOther
Do you charge a fee for any of your program(s) and/or service(s)?

YesNo
If yes, which program(s) and/or service(s)?
Can you describe how your fee based program(s) and/or service(s) benefits the community?

Membership Fees:

The Alliance for a Hunger Free New York is asking for members to submit a pay what you can membership fee based on organization's budget size below. We have provided a suggested table below.

Coalitions: We ask coalitions to join as members and encourage your members to join as either members or affiliate members.

Membership Fees should be submitted through The Alliance Donation Website or sent via check to 32 Essex St. Albany, NY 12206

Membership Fee	Budget Size
$50/year	$50,000 or less
$100/year	$51,000 -$500,000
$250/year	$501,000-$1 million
$500/year	Greater than $1 million
Donations encouraged but not required	Affiliate Member (Organizations and Individuals)

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The Alliance for a Hunger Free New York Membership Application

What's the difference between a member and an affiliate member?

Membership Fees: