BRIDGING THE IMPACT NONPROFIT COLLECTIVE NTX MEMBERSHIP APPLICATION & ENROLLMENT FORM
Share your organization details, programs, and collaboration needs to apply and enroll.
Organization Information
Organization Name
*
Organization Type
*
Please Select
Nonprofit
Charity
Foundation
Social Enterprise
Community-Based Organization
Faith-Based Organization
Other
Year Established
*
EIN
Website / Social Media
City / State
*
First Name
*
Last Name
*
Title / Role
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Collaboration & Capacity
Organization Focus
*
Collaboration & Needs
*
Do you currently have volunteers?
*
Yes
No
Do you have a location for events?
*
Yes
No
Do you need a location for events?
*
Yes
No
Are you open to sharing space with other organizations?
*
Yes
No
Do you have liability insurance?
*
Yes
No
Strongest Assets or Contributions
*
Willingness to Actively Participate In
*
Events
Workshops
Community Outreach
Fundraising
Advocacy
Volunteer Support
Other
Availability
*
Weekdays
Evenings
Weekends
Mornings
Afternoons
Flexible
Other
Select Your Membership Role
*
Please Select
Member
Partner
Collaborator
Volunteer Leader
Advisory Representative
Other
Board & Leadership Roles
Board Member
Board Chair
Vice Chair
Secretary
Treasurer
Committee Chair
Task Force Lead
Other
Committee & Team Involvement
Program Committee
Membership Committee
Events Committee
Fundraising Committee
Communications Team
Community Outreach Team
Volunteer Coordination
Other
Are you open to collaborations with other organizations?
*
Yes
No
Would you like to be matched with another organization?
*
Yes
No
What types of partnerships are you seeking?
*
Visibility & Promotion
*
How actively do you plan to engage in the council?
*
Low
1
2
3
4
5
6
7
8
9
High
10
1 is Low, 10 is High
Funding, Programs, and Readiness
Do you currently have 501(c)(3) status?
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Yes
No
Do you currently have a defined program or service?
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Yes
No
Do you currently have a budget or financial plan?
*
Yes
No
Have you received previous funding or grants?
*
Yes
No
Briefly describe your main program(s) or services
*
Who do you serve? / Target population
*
What impact do you aim to make?
*
What type of collaborations are you most interested in?
*
Do you currently have the following?
*
501(c)(3) determination letter
Budget or financial plan
Program/service description
Strategic plan
Outcome metrics or evaluation plan
Recent grant report
Other readiness documents
What can your organization contribute to the collective?
*
Submit
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