Associate Membership Application - Maine Philanthropy Center

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Associate Membership Application

You can apply for an associate membership by either completing the online form below, or click here to download an Adobe Acrobat (.pdf) version of the application. Instructions and mailing address can be found on the .pdf document.

* Denotes Required Field

Today's Date:

* Contact Name:

Title:

Email:

* Organization Name:

Address
* Street Address

* City

State

* Zipcode

* Phone:

Fax:

Website:

Membership category:

Nonprofit

Professional

Nonprofit Membership Fee:

$50 (Small Nonprofit - up to $75,000)

$100 (Mid-size Nonprofit - $75,000-$250,000)

$250 (Large Nonprofit - over $250,000)

Professional Fee:

$100 (1 to 3 professionals)

$250 (4 to 10)

$500 (10 and over)

Please send a check to
The Maine Philanthropy Center
USM Glickman Family Library
PO Box 9301
Portland, Maine 04104-9301
or pay via credit card after clicking on Send

Payment Method

I will mail a check.

I will pay online.