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2017-18 NACCDO Membership Invoice & Form
Date: June 8, 2017
Invoice Amount: $350
Purpose: July 1, 2017 - June 30, 2018 NACCDO Institutional Dues

INSTRUCTIONS:
1. Complete the membership form below and click “submit”. We want to include your development staff in all NACCDO communications and invitations! Please provide their names, position titles and contact information.

2. Send payment via PayPal (preferred) or check. If paying via Paypal, please refer to the link in your renewal email.

If paying by check, remit to:

Cindy Eller - NACCDO Treasurer
c/o Roswell Park Cancer Institute
Elm & Carlton Streets
Buffalo, NY 14263

Payment form:
Contact Information
Institution Name
Your answer
Address 1
Your answer
Address 2
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Primary Contact for your Institution
Your answer
Primary Contact's Title
Your answer
Primary Contact's Email
Your answer
Primary Contact's Phone
Your answer
Membership/Admin Contact (if different than Primary Contact)
Your answer
Membership/Admin Contact's Email
Your answer
Membership/Admin Contact's Phone
Your answer
Chief Development Officer's Name (to be included on the CDO listserv & CDO Retreat Invitation)
Your answer
CDO's Email
Your answer
The CDO would like to receive all NACCDO Communications
Benchmarking Contact's Name
Your answer
Benchmarking Contact's Email
Your answer
Benchmarking Contact's Phone
Your answer
Cancer Center Type
*If NCI Supported, please list at least one NCI awardee and award time period
Your answer
NACCDO membership is by institution. All development professionals on your staff are encouraged to take advantage of our many member benefits.
We want to include your development staff in all NACCDO communications and invitations! Please list of your institution's development contacts (name, title and email) for the NACCDO communication list. Due to email spam laws, we cannot automatically use prior year's names and email addresses. Contacts will also have access to all member benefits, including the NACCDO LinkedIn Group and the members-only section of the NACCDO website.
First Name
Your answer
Last Name
Your answer
Title
Your answer
Email
Your answer
First Name
Your answer
Last Name
Your answer
Title
Your answer
Email
Your answer
First Name
Your answer
Last Name
Your answer
Title
Your answer
Email
Your answer
First Name
Your answer
Last Name
Your answer
Title
Your answer
Email
Your answer
Important
If you need a hard copy of your completed membership form, please print it BEFORE you click Submit.
Questions?
Please direct any questions regarding NACCDO membership to Cathy Spicola at cspicola@umn.edu. If you have any questions regarding your institution’s payment, please contact Cindy Eller at cindy.eller@roswellpark.org. Thank you!
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