Giving Circle Membership Form

Name*

First NameLast Name

E-mail

Phone Number:

Area CodePhone Number

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

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?*

Giving Circle Focus Areas - What issues do your Giving Circle address through its efforts?*

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.

Giving Circle Membership Profile Form