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FLIC Organizational Member Application 2018-2019
Florida Immigrant Coalition seeks equal rights for immigrants and integration into the civic and cultural life of our communities. We accomplish our mission through coordination of immigrant organizations and community education, organizing and advocating. The Coalition believes in the empowerment of immigrants and the unification of immigrant communities to development amplified voice for immigrant rights. Membership is open to individuals and organizations. Becoming a member allows you to increase your ability to impact important immigrant rights issues.

Benefits:

• Organizational Members select FLIC Board of Directors and help shape Annual Priorities
• Members are empowered to participate in activities and events including training for members and staff, both state and national
• Members receive the a Quarterly newsletter and other important up-to-date information
• Members get exclusive opportunities for organizational development and technical assistance
• Members have indirect access to opportunities and information from more than 10 national partner organizations FLIC belongs to.

Duties:
• Members support the Coalition’s mission and vision and overall goals
• Send representatives to the Annual FLIC Congress (including the General Assembly) and to one of the Regional Meetings
• Members should be represented in 4 Quarterly Membership Calls.
• Pay annual membership dues
• Members support Coalition campaigns, utilizing their organizations strengths and abilities

Name of FLIC Board member or staff person who has worked with your organization and knows your work with the community? *
Your answer
Does your organization subscribe to these duties ? *
Required
Organization Name *
Your answer
Organization Mission
Share your organizations mission in this box. Whats the purpose or focus of your organization. If you have an official mission just copy and paste into the box
Your answer
Types of memberships *
Please check the type of organization that best suit yours
Required
Organization Tax Status (Describe your org)
Your answer
Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Lead Point of Contact Name *
(First, Last)
Your answer
Lead Phone number *
If different from Organization Phone (i.e. Cell Phone)
Your answer
Lead Email *
Your answer
Organization Website
Your answer
Facebook, Twitter Social Media Link
(Example: @FloridaImmigrantCoalition #flimmigrant )
Your answer
Is the lead point of contact with FLIC on your team the one who handles business/financial related actions (i.e. invoices, dues, etc)
(Dues, Invoices, etc)
Admin Point of Contact (if Different from Lead)
(Dues, Invoices, etc)
Your answer
Admin Point of Contact Phone
(Dues, Invoices, etc)
Your answer
Admin Point of Contact Email
(Dues, Invoices, etc)
Your answer
Organizing and Campaign Rep Name
Member of your team that can represent in campaign and organizing calls, meetings, and plans (
Your answer
Organizing and Campaign Rep Phone
Your answer
Organizing and Campaign Rep Email
Your answer
Program and Services Rep Name
Member of your team that can represent your organization in programs and service related work (i.e. citizenship clinics, legal services, or other service related work)
Your answer
Program and Services Rep Phone
Your answer
Program and Services Rep Email
Your answer
If Other - Describe
Your answer
Membership Dues and Contributions for Year 2018-19 (Organizational Membership)
Check Which Applies *
Membership Dues are $100.00. What is your preferred method of payment?
Make checks payable to Florida Immigrant Coalition and mail this form to: Florida Immigrant Coalition, 2800 Biscayne Blvd Suite 200, Miami, FL 33137
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