Nonprofit Network Membership Enrollment Form
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| Organization |
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| Organization Acronym: |
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| Tax ID / EIN # (Employee Identification number): |
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| State |
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| County |
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Please select the category that best describes your organization as used on the IRS Form 990
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| Annual Operating Budget |
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| Please select the appropriate membership level for you or your organization from only one of the three membership categories below: |
| Nonprofit Membership Dues (based on annual operating budget) |
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| Foundation Membership Dues (based on grants awarded annually) |
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| Other Membership Dues |
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| Referred by a current NN member? Please list their name and organization |
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| Member of the Center for Nonprofit Excellence or the Kentucky Chamber of Commerce Executives? If so, receive 50% off NLI membership dues. |
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| Yes, I grant permission for the NLI to communicate with me with the email address provided regarding membership and other news. |
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