501c3 Nonprofit Membership

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Select your annual revenue to determine your membership fee: *

Total Amount

Email Address *

Contact Information

Organization Name *

Alternate Name | Doing Business As

Logo

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Email (Display/Public) *

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Phone *

Fax

Website

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Mailing Address

Street *

City *

State *

ZIP Code *

County *

Colorado Region *

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Physical address is different from mailing address Physical address is same as mailing address

Physical Address

Street

City

State

ZIP Code

Organization Details

EIN *

Mission Statement *

Programs *

Year founded *

Number of FTE (full time employees) *

Number of PTE (part time employees) *

Number of volunteers *

Primary Purpose Code - NTEE *

Additional Purpose Codes - NTEE

You may select multiple options.

Annual budget *

Populations Served *

You may select multiple populations.

Credit Card Information

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

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501c3 Nonprofit Membership