General Details

Select to process a membership, or membership and donation:

MembershipDonation

You are signing up for a membership with the Nonprofit Chamber. Would you also like to make a donation?

Yes, I would like to donate

Is this on behalf of an individual, or an organization? Please select... Individual Student Organization

Individual Membership Level

Please select... Individual Student

I would like my name to be listed on the CCVO member directory

Primary Contact Details

Primary Contact information

Title Please select... Mr. Ms. Mrs. Dr. Prof. Mx.

First Name	Last Name
Email	Retype Email

Primary Contact Phone

Primary Contact Address

Primary Contact Street Address (Line 1)

Primary Contact Street Address (Line 2)

Primary Contact City

Primary Contact State/Province

Please select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau

Primary Contact Zip/Postal

Primary Contact Country

Please select... CA US

I would like to include my organization's details with my individual membership?

Yes

Job Title

Organization's Name

PRIMARY CONTACT Role

Primary Contact Job Title

Primary Contact not CEO:

I am not the CEO

Executive Details

Executive Job Title

Executive Title

Please select... Mr. Ms. Mrs. Dr. Prof. Mx.

Executive First Name

Executive Last Name

Executive Contact Email

Retype Executive Contact Email

Organization Details

Organization Information

Organization Name

Organizational Legal Name (if different)

General Organization Email

Retype General Organization Email

Organization Phone

Organization Address

Organization Street Address (Line 1)

Organization Street Address (Line 2)

Organization City

Organization State/Province

Please select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau

Organization Zip/Postal

Organization Country

Please select... CA US

Organization Industry

Select your organization's sector

Please select... Nonprofit Business Government Agency

Select your organization's sub-sector

Please select... Arts & Culture Business Development Education & Research Environment & Animal Welfare Faith & Religion Fundraising & Volunteerism Government Health Housing International Law, Advocacy & Politics Other Professional Association or Union Social Services Sports & Recreation

Organization Membership Details

Please list my organization on the online member directory

Please list my organization's website on the online member directory

Please enter the URL you wish to use for your directory listing

Please select your organization's configuration

Please select... Nonprofit (Operating Budget less than $100K) Nonprofit (Operating Budget $100K - $500K) Nonprofit (Operating Budget $500K - $1.5M) Nonprofit (Operating Budget over $1.5M) Business (less than 50 employees) Business (more than 50 employees) Government Agency

Donation Details

Sustainer Amount

Please select... 1000.00 2500.00 5000.00 10000.00

Contact Information

First Name

Last Name

Email

Phone

Billing Address

Street Address (Line 1)

Street Address (Line 2)

City

State/Province

Please select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau

Zip/Postal

Country

Please select... CA US

Payment Information

Name on Card

Credit Card Number

MM

YY

CVV

Stripe Information