Community Partner Membership Application
To apply for membership please complete all questions. You may add up to Four additional Individual Members.
Name of organization
*
Name
*
First Name
Last Name
Job title:
*
EX: Executive Director
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Office Number
*
Cellular Number
*
Work Number
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 Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
2. Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
3. Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
4. Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Type of Business
*
EX: Nonprofit - 501c3, 501c4, LLC, Sole Proprietorship etc.
EIN#
*
Yearly budget:
*
below $50,000
above $150,000
above $250,000
above $500,000
Geographic Area your Organization serves
*
Organizational Needs
Topics you are interested in learning about:
Are you interested in serving on a committee?
*
Yes
No
Not at this time
Are you interested in assisting with planning events?
*
Yes
No
Not at this time
Please Share your Organization Logo
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As a member of The Dallas Legacy Mission Coalition of Hispanic Nonprofits of North Texas - TDLMCHNNT - You agree that you grant us permission to share your name, organization information, logo, photographs on social media, newsletter, and website.
*
Yes
No
By signing below you understand that this application is not a guarantee of acceptance into TDLMCHNNT. There is no membership fee. We reserve the right to update and change the policies of TDLMCHNNT as we deem necessary; with proper notice given to all parties before they go into effect. You also agree and understand that your nonprofit organization must maintain its good standing with the IRS.
*
Signature Date
*
-
Month
-
Day
Year
Date
Apply for Membership
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