CIPC Organizational Membership Application 2016
Instructions for Application:
1) Fill out form completely
2) Pay online or mail check to address provided
3) CIPC staff will follow up on the receipt of applications shortly after submission
ORGANIZATION INFORMATION
Organization Name *
Please write out the complete name of your organization for public listing.
Your answer
Street Address *
Include unit number if applicable
Your answer
City *
Your answer
Zip Code *
Your answer
Organization's Website
Your answer
Organization's Mission *
Your answer
Organization's Non-profit Status *
Required
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