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 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 (

2) USCAN's 5-year Strategic Plan (

3.) USCAN's Justice Equity Diversity & Inclusion (JEDI) statement, checklist & definitions (

4.) If you do not have a 990, please download, sign and submit the No Fossil Fuel Affidavit to (
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Email *
Full name *
Date *
Primary contact's title & phone number *
Organization's Name, website & social media *
How is this organization incorporated? *
Please include a short paragraph to be used to introduce your organization to the membership that includes your current work and recent accomplishments: *
What is your organization's billing contact name, title, email and phone number? *
What is the annual budget of your organization and approximate budget for climate related work? *
Please list your top five funding sources for the last twelve months *
In the space below, share why you want to join USCAN. *
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? *
What are the main partners and coalitions with which you currently work? *
How did you hear about us, if not referred by a USCAN member? *
Have you read the Jemez principles and are you agreeable to utilizing through your work with USCAN?
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Have you read our 5yr Strategic Plan?
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