Step 1:
Organization Information
My organization is a registered 501 (c)(3)
*
Yes
No
Official Organization Name
*
Please use the registered name of your organization
Organization DBA
If your organization operates using a name different than the registered name, please include the alternate name here
Organization EIN
*
Available on your IRS 501 (c)(3) determination letter
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Website
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Step 2:
Contact Information
*
First Name
Last Name
Email
*
Phone Number
*
Title
*
Submit
Should be Empty: