NPRC Annual Membership Registration Form

NPRC Annual Membership Registration Form
Annual Membership Fee for 2025 is $240.00 and will be invoiced upon completion of your Registration Form.

Organizational Details:
Is this a New Membership or Renewal Membership?*
Non-Profit Organization Name:*
Federal Tax ID Number:*
Organizations Executive Director Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail of Executive Director*
example@example.com
What is your organizations Mission Statement:*
Is your organization a member of the local Basic Needs Network (BNN) ?*
Of the types of items listed below, which are MOST needed by your organization on a monthly basis?

Hygiene SuppliesCleaning SuppliesBedding/BedsFurnitureOffice/School SuppliesOther
What demographic of individuals does your organization serve in the Abilene community?*
Approximately how many individuals does your organization serve on a monthly basis?*
Due to requirements of our donor organizations and companies who help stock our Non-Profit Resource Center, we must clearly communicate that all items received by member organizations are to be used either for their organizations office needs (i.e. cleaning supplies used to clean their office, bathroom, etc.) or be provided for direct client support (i.e. items provided to a client for their use at home, etc.). No items received are for personal use by your organizations staff for personal needs (i.e. you are not to acquire deodorant for your staff to personally use or diapers for staff to use on their own children). Additionally, no organization may sell, barter, trade or charge a fee for any product received from the NPRC. Any organization that is determined to be utilizing the NPRC for staff personal gain will be removed from the program and Membership Fees will not be returned! Please initial below to confirm that you 1) understand this policy and 2) will abide by this policy.
Will you be willing to recommend us?

YesNoMaybe

Please provide the names and contact information for authorized "shoppers" for your organization at our Non-Profit Resource Centerl:*

Rows	Full Name	Contact E-Mail	Contact Phone:
1
2

Signature
Should be Empty: