Membership Application
Date:___________ (Membership is by calendar year [Jan-Dec])
Name:__________________________________________________________________
Organization:_____________________________________________________________
Address:________________________________________________________________
City-State-Zip:___________________________________________________________
Phone:______________ Fax:_______________
Email:____________________________ Web Site:_____________________________
Type of Membership
____Business/Org. with budget at least $1,000,000 (Fee: $125)
____Business/Org. with budget less than $1,000,000 (Fee: $65)
____Church/Congregation (Fee: $50)
____Individual (Fee: $25)
____Homeless/Formerly Homeless (Fee: $0)
Are you willing to serve on a committee? If so, check below:
____Resource Development
____Research and Evaluation
____Education and Training
____Finance and Personnel
____Nominating
____Planning
Mail Completed Application and
Membership Fee to:
The
Chattanooga, TN 37404