New Member Application 2021
Hello! Welcome to the first step of the USCAN Membership application process. To begin, we invite you to review a few documents (below), and complete this application form.
Once you submit this application please email
membership@usclimatenetwork.org
your organizations most recent annual report (if you have one) and your 990 tax form including the schedule B. We are reviewing finances to determine if applicants receive funding from fossil fuel companies. If sending over taxes is difficult there is an alternative for our financial review outlined in point "4.)" below.
Important links to read through before applying to USCAN:
1). Jemez Principles for Democratic Organizing (
https://www.usclimatenetwork.org/principles-of-working-together
)
2) USCAN's 5-year Strategic Plan (
https://www.usclimatenetwork.org/strategic_plan_2017_2022
)
3.) USCAN's Justice Equity Diversity & Inclusion (JEDI) statement, checklist & definitions (
https://www.usclimatenetwork.org/justice_equity_diversity_and_inclusion
)
4.) If you do not have a 990, please download, sign and submit the No Fossil Fuel Affidavit to
Membership@usclimatenetwork.org
(
https://docs.google.com/document/d/1H56zo1wbRcyF7UDX6nj26gb76koOyj42xCDoFvi0h3k/edit?usp=sharing
)
*Pakollinen
Sähköposti
*
Sähköpostiosoitteesi
Full name
*
Oma vastauksesi
Date
*
Päivämäärä
Primary contact's title & phone number
*
Oma vastauksesi
Organization's Name, website & social media
*
Oma vastauksesi
How is this organization incorporated?
*
501(c)(3)
501(c)(4)
501(c)(5)
Religious institution not with any official status
Tribal Government
Registered as state non profit or similar designations
Organization has a fiscal sponsor - If you have a fiscal sponsor we require a letter from them acknowledging they support your application.
Muu:
Please include a short paragraph to be used to introduce your organization to the membership that includes your current work and recent accomplishments:
*
Oma vastauksesi
What is your organization's billing contact name, title, email and phone number?
*
Oma vastauksesi
What is the annual budget of your organization and approximate budget for climate related work?
*
Oma vastauksesi
Please list your top five funding sources for the last twelve months
*
Oma vastauksesi
In the space below, share why you want to join USCAN.
*
Oma vastauksesi
Are there any USCAN members who you currently work with who can talk to about your work. List below. Were you referred by a USCAN member?
*
Oma vastauksesi
What are the main partners and coalitions with which you currently work?
*
Oma vastauksesi
How did you hear about us, if not referred by a USCAN member?
*
Oma vastauksesi
Have you read the Jemez principles and are you agreeable to utilizing through your work with USCAN?
Yes
No
Muu:
Tyhjennä valinta
Have you read our 5yr Strategic Plan?
Yes
No
Tyhjennä valinta
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