Nonprofits Working Clean

**Registration Information:**
First Name
Last Name
Title
Email
Organization (please avoid using acronyms and abbreviations)
Tax ID / EIN #
Address
City
State
Zip
County:
Phone
Fax
Website
How did you find out about this event?
United Way of the Bluegrass Member Agencies or Nonprofit Network members? Check box to receive membership rate.
Special Requirements:
Yes, I grant permission for the NLI to communicate with me with the email address provided regarding this event and others.
ADDITIONAL REGISTRATION INFORMATION ~ All registrants must select "Register and Pay Online" below to complete the online registration process. ~ United Way of the Bluegrass Member Agencies and Nonprofit Network Members will receive the discounted registration rate. Once selecting "Register and Pay Online" you will be directed to the homepage. If you do not receive a confirmation email with in 4 business days please contact us at 859.257.2542 or emailus@kynonprofits.org. ~ Once your registration has been submitted, you will receive a confirmation email within 2-3 business days.

Please enter your credit card information:

Name as it appears on card:

Account Number:

CVV2 Code (3 digit number on the back of card):

Expiration Month (MM):

Expiration Year (YY):

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