MEMBERSHIP ENROLLMENT FORM

Please fill in the information below to become a WFN member. Fields displayed in bold are required.

Contact Information
Organization Name  
First Name  
Last Name  
Title  
Address  
City  
State/Province  
Postal Code/Zip  
Country  
Phone number  
Fax  
E-mail Address  
Website Address  
Previous Membership Information
Has your organization been a WFN member in the past?    Yes     No
If yes, past membership start year  
past membership end year  
Membership Type / Dues Level
Please indicate your Partner or Associate member dues level:
 
Our organization has a combined annual operating budget and net cash assets* of $500,000 USD or more:
           Partner Member $2500.00 USD dues level
           Associate Member $2500.00 USD dues level
 
Our organization has a combined annual operating budget and net cash assets* of less than $500,000 USD:
           Partner Member $1000.00 USD dues level
           Associate Member $1000.00 USD dues level
 
Additional Contribution to WFN    USD
 
* Operating budgets include administrative, grant making, fundraising, and programmatic budgets. Net cash assets include endowment and reserve funds.
Payment Option
Please choose your payment option:
 
 Check   (Please make checks payable to Women’s Funding Network.
Mail check to: 1375 Sutter St., Suite 406, San Francisco, CA 94109.)
 
      Credit Card    Visa     MasterCard     American Express
  Credit Card Number  
  Expiration Date  
 
(Please note: this server is not yet a secure socket server. Credit card information will be processed manually by WFN staff.)
Organization Profile
Type of Foundation    Private/Family Foundation
   Public Foundation
   Women’s Fund within a Community Foundation
   Public Fund within a Larger Organization
   Other (please specify):
        
 
General Staff
(please check all that apply)		    New Executive Director (up to one year)
   No Staff
   1-5 Staff
   6-10 Staff
   11-25 Staff Members
   Over 26 Staff Members
 
Year Foundation/Fund Was Created   
 
Financial Information
Please submit a copy of your most recent 990 or copy of your audited financial statement. The information can be emailed to finance@wfnet.org, faxed to 415-441-0827 or mailed to 1375 Sutter St. Suite 406, San Francisco, CA 94109.
 
Grantmaking Areas
(please check all that apply)		    Advocacy
   Arts and Culture
   Capacity Building
   Discrimination
   Economic Justice and Development
   Girls
   Health Care
   Human Rights
   Leadership Development
   Philanthropy
   Reproductive Rights
   Technology, Science, Math
   Violence Against Women/Girls
   Welfare Reform
   Other (please specify):
        

Women’s Funding Network - 1375 Sutter Street, Suite 406, San Francisco, CA 94109, USA - 415.441.0706 - Privacy Policy