Community Connection Application

Please complete the application form below so the board can vet your organization and finalize the line-up.

Name of Non-Profit*
Name of Contact Person*
Contact Person's Position
Address*
Street Address City State / Province / Region ZIP / Postal Code
Email*
Phone*
Non-Profit EIN#
How long has the NPO been in existence? (A minimum of 1 year from the IRS Determination Letter is required.)
Who is your target market & what do you do for them?
In what way do you think ConnectW could benefit your organization? What kind of specific needs do you have? Bringing this information to our members in your presentation will be helpful.
Are there any pending legal or other issues ConnectW should be aware of? If so, please explain.
Name
This field is for validation purposes and should be left unchanged.

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Password

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