2027 NEW NONPROFIT MEMBERSHIP FORM

Organization Information

Thank you for your interest in joining NYCON. If you have had a membership previously (even through an association or funder), please do not fill out the form below. Visit nycon.org/renew to ensure your organization's information and membership are correct.

If you receive an error when accessing this form, please review our website for common issues or contact membership@nycon.org.

Please Note:

Unfortunately, we cannot accept American Express cards. If that is your only method of credit card payment, please click to print our application and pay by check.

Questions? Please contact our Membership team: (800) 515-5012 ext. 126 or membership @nycon.or g.

Organization Name

Organization Street Address

Organization City

Organization State

Organization Zip

County

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

Organization Phone

Website

Employer ID # (EIN)

Operating Budget (to nearest dollar)
NOTE: Enter Numbers Only! no dollar sign ($), commas (,) or decimal points (.)

$

Percent of Budget from Government

%

Year Incorporated

NYCON holds Executive Director Retreats. Does your Executive Director have between 6 months to 5 years of experience?

YesNo

Primary Service Area

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

Number of Employees (Full Time 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

Additional Contact

Add up to 6 additional contacts through this form.

Contact Salutation

Contact First Name

Contact Last Name

Contact Title

Email

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!

Window ClingMagnetNo thank you

Payment Information

Transaction Information

Membership Subtotal

$

Calculated based on organziational budget.

Total Cost

$

Including addons and/or discounts if applicable.

Discount Code

Discount Amount

$

Payment Information

Cardholder First Name

Cardholder Last Name

Cardholder Street Address

Cardholder City

Cardholder State

Cardholder Zip

Card Number

Card Expiration Month (Use two digits, "04" for April)

CVV

Card Expiration Year (Use four digit year "2027")

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

PROOF OF PAYMENT:
Your payment receipt will appear on the following screen, please download it as a PDF or print it or your records. This receipt will also be emailed to the organizational email listed on page 2. You can also access your most recent membership transaction on your Member Dashboard.

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