Membership Application Membership TypePlease select... New (First Time Member) Renewal Display Our Data for Review / Update* *Data only appears if you followed a custom link specific to your organization's renewal. Organization Federal ID Number Address City State Zip CountyPlease select... Arlington Alexandria Fairfax Loudoun District Prince George's Albemarle Anne Arundel Augusta Baltimore Charles Columbia Culpepper Fredericksburg Henrico Montgomery Prince William Richmond Roanoke Shenandoah Suffolk Warren Washington Other Invoice / Quote Number Leave blank if not applicable. Primary Contact Contact FunctionPlease select... Executive Leadership Finance Operations Marketing / Communications Other First Name Last Name Job Title Primary Contact Email Phone Executive Leadership Contact Information First Name Last Name Job Title Phone Executive Leadership Email CEO Contact Id Contact FunctionPlease select... Executive Leadership Additional Organization Contacts Contact FunctionPlease select... Finance Operations Marketing / Communications Other First Name Last Name Job Title Email Phone Contact Id Phone Number Website (or Facebook page) Full-time Employees Part-time Employees Number of People Served Annually Mission Area/s (check all that apply)HomelessAdvocacyAnimal RelatedArts, Culture & HumanitiesCivicEducationEnvironmentFaith-basedHealth & NutritionLegal/professionalPhilanthropySeniorsYouthOther BenefitsWhich Center benefits are you most interested in?advocacyannual award programsboard developmentcommercial & liability insurancecommunication spotlightsemployee retirement plansnetworkingnonprofit resource centeronline job bankprofessional developmentunemployment trust Geographic Area Served (check all that apply)Which best describes the community you serve?NW Washington, DCNE Washington, DCSW Washington, DCSE Washington, DCMontgomery County, MDPrince George’s County, MDAlexandria, VAArlington County, VAFairfax County, VALoudoun County, VAPrince William County, VANationalInternationalOther If annual expenses are Please select... $24,999 and below, dues are $265 $25,000- $49,999, dues are $315 $50,000- $99,999, dues are $425 $100,000- $199,999, dues are $575 $200,000- $399,999, dues are $739 $400,000- $699,999, dues are $949 $700,000- $999,999, dues are $1,115 $1 mil- $1.9 mil, dues are $1,275 $2 mil- $3.9 mil, dues are $1,515 $4 mil- $5.9 mil, dues are $1,845 $6 mil- $9.9 mil, dues are $1,998 $10 mil - $14.9 mil, dues are $2,225 $15 mil +, dues are $2,495* dues structure as of 05/2023 IRS Form 990 Discount Code Payment Information Amount Payment MethodPlease select... Credit Card ACH The Center for Nonprofit Advancement is no longer accepting check payments. To request an ACH payment, please emailing Erica at ericaj@nonprofitadvancement.org or Adanech at adanech@nonprofitadvancement.org. Credit Card Details Cardholder's Full Name Card Number Card Security Code (CSC) Expiration Month Expiration Year Authnet_Hidden_Fields Account Id Contact Account Id Primary Contact Id Payment Status reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA. Contact Information
