Application to Join NYPAN
As a Chapter or Affiliate
Name of Organization: *
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Region or issue (for example: "Schuyler County" for a chapter, or "upstate environmental activism" for an affiliate) *
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(Note that Chapters fall under NYPAN's corporate structure, while Affiliates have their own structure, accountants, etc.)
Name of contact person: *
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Address: *
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Email: *
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Phone number(s): *
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Address of group (if different from contact person's address)
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Legal status or plans for legal status of group (incorporated, 501(c)4 tax status, non-profit, etc.) *
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Relationship of contact person to group: *
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Date group was formed: *
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Nature of group: (mission, issues....) *
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Recent group activities: *
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Why does the group want to become a NYPAN chapter / affiliate? *
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Does the group support NYPAN's Mission and Goals (see attached)? *
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How many members does the group have? (if not known, give approximate number or describe situation.) *
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What are your criteria for membership? (what are members expected to give or do?) *
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Do you charge dues and if so, how much? *
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Does your group have a mission statement? If so, please attach a copy.
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Does your group have bylaws? If so please attach a copy.
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Please be aware that your group is expected to have adopted a set of bylaws by their 6th month of membership in NYPAN. NYPAN can assist you with this process by supplying model bylaws for your group to modify.
Would you like a NYPAN rep to come attend a membership meeting or other meeting of your group? If so, please describe.
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Any other comments or questions:
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