DC Breastfeeding Coalition Membership Application (Silver Level)
Name:
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Credentials/Experience:
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Address:
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Phone Number (daytime):
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Phone Number (evening):
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Website (if applicable):
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Email Address:
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Workplace:
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Age range
Gender
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How do you describe your race/ethnicity?
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How would you describe yourself? (ex: hardworking, goal-oriented, breastfeeding mom, etc.)
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Are there any special areas of interest/projects that you are working on?
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Other organization affiliations:
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How did you hear about DCBFC?
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Which committees are you interested in serving on?
DCBFC Membership Levels
Bronze Membership: Mentorship Program: $25 ($50)

> Must submit an application for approval by the Board of Directors
> Application must include a letter of recommendation
> Individual pays $25, remainder ($25) matched by DCBFC scholarship fund
> Mentored by DCBFC member, paired based on personal and professional goals
> Agrees to serve on a committee or work group for a minimum of one year of service
> Monthly meeting announcements, minutes and periodic email updates and notices
> Network with other lactation specialists, health professionals, advocacy partners, breastfeeding supporters, moms and families
> Non-voting member

Silver Membership: Community Member/Community Health Worker/Student: $50

> Community members include breastfeeding mothers and advocates
> Community health workers include patient care technicians, doulas, lactation counselors, unmentored breastfeeding peer educators/counselors, etc.
> Student members must be enrolled at an accredited university and/or college
> Eligible for board membership and executive team positions
> Monthly meeting announcements, minutes and periodic email updates and notices
> Network with other lactation specialists, health professionals, advocacy partners, breastfeeding supporters, moms and families
> Voting member

Gold Membership: Health Care Workers : $75

> Eligible for board membership and executive team positions
> Eligible for inclusion in the Speakers Bureau Network
> Committee membership and/or work group participation is mandatory
> Printed copies of the " DC Breastfeeding Coalition Resource Guide" available for distribution upon request
> Monthly meeting announcements, minutes and periodic email updates and notices
> Network with other lactation specialists, health professionals, advocacy partners, breastfeeding supporters, moms and families.
> Voting member

Platinum Membership: Business/Organization: $300

> Considered active member through monetary contribution
> Includes a full-page ad in the DC Breastfeeding Resource Guide
> A supply of free "Breastfeeding Resource Guides"
> Receives periodic email updates and notices
> Network with other lactation specialists, health professionals, advocacy partners, breastfeeding supporters, moms and families.
> Non-voting member

Friends of DCBFC: Individual Supporter: Any dollar amount

> Willing to support the DCBFC in their efforts through a financial gift of any size
> Receives periodic email updates and notices
> Membership not included

Your financial support and/or participation as a member of District of Columbia Breastfeeding Coalition (DCBFC) enables our Coalition to thrive. Membership dues fund advocacy, outreach efforts, scholarships, and allow us to stay viable as a non-profit 501 (C) (3). Our organization is focused on promoting, protecting, and supporting culturally-sensitive programs that build awareness and understanding of the preventive health benefits of breastfeeding. Through its breastfeeding research, advocacy, and educational activities, the coalition seeks to reduce health disparities--particularly among the most vulnerable infants and children living in our communities.

Which membership level are you joining under?
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Thank you for taking the time to submit this interest form! We look forward to serving the community with you.
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