NEW MEMBERSHIP APPLICATION - 2024 Membership Year

Page 1

This application is for NEW NYCON members only. If you're renewing an existing membership, please go back and log into the Member Dashboard.

Thank you for your interest in joining New York Council of Nonprofits (NYCON). We look forward to providing value to your staff and board members.

NYCON Membership is based on the calendar year, January 1- December 31.
Please send any questions to membership@nycon.org.

Organization Name

Organization Street Address

Organization City

Organization State

Organization Zip

County

Organization E-mail Address - Credit card receipt will be emailed here.

Organization Phone

Website

Employer ID # (EIN)

Operating Budget- Enter Numbers Only! No Dollar Sign, No Comma

Percent of Budget from Government

Year Incorporated

NYCON holds Executive Director Retreats, please indicate if your Executive Director has between 6 months to 5 years experience.

YesNo

The questions below assist in advocacy efforts.

Primary Service Area

Congressional District (Look up by zipcode: My Congressional District (census.gov))

Number of Employees (FTE)

Number of Board Members

Staff Information

Primary Contact

Primary Contact Salutation

Primary Contact First Name

Primary Contact Last Name

Primary Contact Email

Primary Contact Title

Secondary Staff Contact

Secondary Contact Salutation

Secondary Contact First Name

Secondary Contact Last Name

Secondary Staff Email

Secondary Contact Title

Board President

Board President Salutation

Board President First Name

Board President Last Name

Board President Email

Board President Phone Number

Display your pride as a NYCON Member

While supplies last, we have a new way to showcase your pride as NYCON member! We'd like to offer a Proud Member window cling or magnet for you to display. Select your preference below and we'll get one in the mail to you. Thank you for your membership.

NYCON Proud Member

Window ClingMagnetNo thank you

Payment Information

Subtotal

$

Discount Code

Discount Amount

Total Cost

$

Your submission may take up to 60 seconds to process. Please only click "Submit" once.

Your payment receipt will be emailed to the organizational email on page 1.

Credit Card Information

Cardholder First Name

Cardholder Last Name

Cardholder Street Address

Cardholder City

Cardholder State

Cardholder Postal Code

Card Number

CVV

Expiration Month ("02")

Expiration Year ("2027")

Authnet_Hidden_Fields