CIO MEMBERSHIP APPLICATION
Become a Center for Intercultural Organizing (CIO) member and help create a stronger, more vibrant, more inclusive democracy. At the Center for Intercultural Organizing, immigrants, refugees and allies work across cultural lines to advance the rights and liberties of all. Join us!
Name
*
Address
*
City, State Zip
*
E-mail Address
Daytime Phone
Evening Phone
Cell Phone
What is the best way to contact you?
*
Daytime Phone
Evening Phone
Cell Phone
E-mail
Home Address
Gender
Birthday
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
In order to make our organization work for all participants, we need to know some basic information about our members. We do not share this information nor do we use it to discriminate against people.
Which best describes you
*
I am a U.S. born citizen
I am a naturalized citizen
I am an international student
I am an international worker
I am an immigrant
I am a refugee/asylee
Country of Origin
*
Ethnicity
*
Native Language
*
Second Language
Third Language
MEMBERSHIP DUES: Membership dues are sliding-scale, beginning at $5 per month ($60 per year). We encourage our members to select a dues amount that works for their budget. For individuals who cannot afford to pay the $5 monthly minimum dues, we have a labor-equity program that allows members to contribute 6 hours of volunteer work per year instead of paying monetary dues.
Are you able to pay membership dues?
*
Yes, I am able to pay membership dues
No, I would like to participate in labor equity
How much are you able to pay in dues per year?
I would like to pay my dues by:
Cash
Check
Credit/Debit Card
Electronic Funds Transfer
Not Applicable (labor equity)
How often would you like to pay your dues?
I would like to pay monthly
I would like to pay quarterly
I would like to pay twice per year
I would like to pay yearly
PAYING DUES ONLINE: If you are able to pay membership dues, we encourage you to pay online through a debit card, credit card or Paypal account. If you would like to make a dues payment today, please indicate the amount you would like to pay in the following box, and you will be taken to a secure payment site courtesy of Paypal after this form is submitted. If you do not wish to make an online payment, leave the box blank.
ACTIVE OR SUPPORTING MEMBER: We understand that people have busy lives. Because we rely upon our members to create and implement all of our programs, campaigns and strategies for change, we have two categories of membership: active members and supporting members.
What kind of member would you like to be?
*
I would like to be an active member. Please connect me with CIO involvement opportunities
I cannot be active. Please consider me a supporting member.
Submit
Should be Empty: