Fair Budget Coalition Organizational Membership Form 2019-2020
This is the application for organizational members. If you are signing up for an individual, please use the "Individual Membership" link on our website at
www.fairbudget.org/membership
Please make checks payable to our fiscal sponsor:
Social Good Fund, with “FBC Membership Dues” in the memo line.
Payments accepted online but include a 4% processing fee.*
bit.ly/FBCMembership2020
* Required
Email address
*
Your email
Organization Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Advocacy Contact Name
*
Your answer
Advocacy Contact Email
*
Your answer
Add to listserv?
Yes
No
Membership Dues Contact Name
*
Your answer
Membership Dues Contact Email
*
Your answer
Add to listserv?
Yes
No
Communications Contact Name
*
Your answer
Communications Contact Email
*
Your answer
Add to listserv?
Yes
No
Please list other organizational contacts you'd like to have added to our listserv: names and email addresses
Your answer
Issue Groups You'd Like to Be Involved With:
*
Housing Security
Food Access, Justice and Equity
Healthcare
Economic Justice
Fair Taxes and Public Deals
Community Safety
Required
Organizational Member Dues
$150 - annual budget up to $249,999
$250 - annual budget $250,000-$499,999
$350 - annual budget $500,000-$749,999
$500 - annual budget $750,000-$999,999
$750 - annual budget $1,000,000-$1,999,999
$1,000 - annual budget $2,000,000-$4,999,999
$2,000 - annual budget $5,000,000 and above
I’d like to make an additional donation of
Membership Swap (Only available for Coalitions FBC Participates In)
Organization is unable to pay membership dues and would like to provide an in kind donation in lieu of dues (Please contact Stephanie to arrange this option)
Please check
*
New Member
Renewal
Required
Date Submitted
*
MM
/
DD
/
YYYY
Submitting Payment
Please make checks payable to our fiscal sponsor,
Social Good Fund,
with “FBC Membership Dues” in the memo line.
All checks can be mailed to:
Fair Budget Coalition
1419 V St NW
Washington, DC 20009
A copy of your responses will be emailed to the address you provided.
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