Giving Circle Membership Form

Giving Circle Membership Profile Form

Please complete if you are an existing Giving Circle interested in joining CIN.
Name *

First Name Last Name
E-mail
Phone Number:

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Giving Circle
Giving Circle Name *
What year did your Giving Circle start? *
Year Only
How many members are in your Giving Circle? *
Giving Circle Role - What position do you have with your Giving Circle? *

President Vice President Treasurer Secretary Parliamentarian Financial Secretary Member (no leadership position)
Giving Circle Focus Areas - What issues do your Giving Circle address through its efforts? *

Youth Education Poverty Technology Arts Healthcare Economics
Please upload your Giving Circle logo.

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Please upload a membership contact list for your Giving Circle members.

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The list will only be used for CIN membership purposes and will not be spread or distributed. A separate submission is acceptable. Cancel of

Giving Circle Membership Profile Form