Associate Member Renewal Application - Maine Philanthropy Center

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Associate Member Renewal Application

* Denotes Required Field

Today's Date:

New Contact Information for Organization

* Name:

Title:

* Email:

* Organization Name:

Address:
* Street Address

* City

State

* Zipcode

* Phone:

Fax:

Website:

Membership category (check either Nonprofit or Professional and select your fee structure):

Nonprofit

Nonprofit Fees:

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

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

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

Professional

Professional Fees:

$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.