Faith Works Network (FWN) Membership Application

Faith Works Network (FWN) Application Form
FWN is one of the Region’s Faith, Community, and Civic Alliances, focused on faith-led and collaborative economic development. It consists of a coalition of clergy members, local stakeholders, organizations, businesses and individual partners that believe in empowering and enriching the lives of people, specifically in the Gary, IN Northwest Indiana region. Our commitment to be Faith-Led, Collaborative and Inclusive are at the core of everything we do.

We invite you to join our vision of working together with other like-minded and like hearted individuals as we lead Gary to become an economic driver of Northwest Indiana. Now is the perfect time to be a part of (FWN)! We have a number of exciting opportunities available on a variety of strategic pillars: Farm to Table, Business Growth, Holistic Healing, Community Safety, Environmental Justice, and Renewable Energy. We are happy to help you find something that meets your interests to serve your business, organization, community and / or personal growth.

This membership Agreement is entered into by FaithWorks Network, Inc. and those Organizations, Business owners or individuals who choose an inclusive approach in doing business with this organization. All are encouraged to be a part, who demonstrate selfless passion in the grace of collaboration for a cause that is greater than themselves. To become a member, please fill out the form below and press the submit button.
Member Intake Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Please upload a professional picture of yourself for us to use for acknowledgement purposes.

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Do you have a business?*

YesNo
Business/Organization Name (if this does not apply, type N/A)*
Website Address (if this does not apply, type N/A)*
Please upload your Certificate of Organization, if you're a business.*

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Please share your EIN.*
What type of annual membership are you applying for?*

Faith-Based Organization- $2,500Community Organization- $2,500Business Organization- $2,500Clergy- $100Business Owner (Sole Proprietor or Single Member LLC)- $100Community Member- $20
Areas of Interest of FEED Gary Plan*

Pillar 1: Farm to TablePillar 3: Holistic HealingPillar 4: Community SafetyPillar 2: Business GrowthPillar 4: Community SafetyPillar 6: Renewable Energy
What projects are you working on currently (if this does not apply, type N/A)?*
Why are you passionate about working on this project (if this does not apply, type N/A)?*
How did you hear about us?*

If you were referred to Faith Works Network, please share who referred you. (If this does not apply, please put N/A in each cell).*

	Full Name	Email Address	Contact Number	Address
1

Choose your annual membership and make payment:*

Faith-Based Organizaiton

$2,500.00 for each year

Community Organization

$2,500.00 for each year

Business Organization

$2,500.00 for each year

Clergy

$100.00 for each year

Business Owner

$100.00 for each year

Community Member

$20.00 for each year

Credit Card

I hereby understand that upon applying for membership, this payment is non-refundable.*

Yes
Date*

MonthDayYear
Hour MinutesAM/PM Option
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Faith Works Network (FWN) Application Form

Credit Card