IFIPAffiliateForm
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AFFILIATE LEVEL APPLICATION Affiliation in International Funders for Indigenous Peoples is open to those who are aligned with our Mission, Vision and Values but are not a donor themselves nor a primarily grantmaking organization. We welcome individuals or institutions concerned about the livelihood, culture, and well-being of Indigenous Peoples and their communities. Affiliate level is open to: • Indigenous-led organizations that serve Indigenous communities. • Nonprofit service and support organizations and entities that provide services and support to the philanthropic sector and have an active involvement in Indigenous communities. • For-profit service and support organizations that provide services and support to the philanthropic sector and/or have an active involvement in Indigenous communities. ORGANIZATION INFORMATION FULL NAME OF ORGANIZATION (PLEASE TYPE OR PRINT CLEARLY) CONTACT PERSON ADDRESS CITY STATE ZIP CODE COUNTRY TEL FAX E-MAIL WEBSITE YEAR FOUNDED? YEARLY ASSETS YEARLY GRANT LEVEL % OF FUNDS TO INDIGENOUS AREA(S) OF INTERNATIONAL FOCUS 1) What is the focus of your support or work with Indigenous communities? 2) What regions or countries do you work in? 3) What do you most want to get out of being an affiliate of IFIP? 4) What do you hope to contribute to the IFIP network and how is your mission in line with ours? ______________________________________________________________________________________________ 5) How did you learn about IFIP? __ Affiliate Membership Application 1
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IFIP Affiliate Application Form
Transcript of IFIPAffiliateForm
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AFFILIATE LEVEL APPLICATION
Affiliation in International Funders for Indigenous Peoples is open to those who are aligned with our Mission, Vision and Values but are not a donor themselves nor a primarily grantmaking organization. We welcome individuals or institutions concerned about the livelihood, culture, and well-being of Indigenous Peoples and their communities.
Affiliate level is open to: Indigenous-led organizations that serve Indigenous communities. Nonprofit service and support organizations and entities that provide services and support to the
philanthropic sector and have an active involvement in Indigenous communities. For-profit service and support organizations that provide services and support to the philanthropic
sector and/or have an active involvement in Indigenous communities.
ORGANIZATION INFORMATION
FULL NAME OF ORGANIZATION (PLEASE TYPE OR PRINT CLEARLY)
CONTACT PERSON
ADDRESS
CITY STATE ZIP CODE COUNTRY
TEL FAX E-MAIL
WEBSITE YEAR FOUNDED?
YEARLY ASSETS YEARLY GRANT LEVEL % OF FUNDS TO INDIGENOUS AREA(S) OF INTERNATIONAL FOCUS
1) What is the focus of your support or work with Indigenous communities?
2) What regions or countries do you work in?
3) What do you most want to get out of being an affiliate of IFIP? 4) What do you hope to contribute to the IFIP network and how is your mission in line with ours?
______________________________________________________________________________________________
5) How did you learn about IFIP? __ Affiliate Membership Application 1
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AFFILIATE OPPORTUNITIES (In lieu of membership, for those organizations that do not qualify for membership but wish to support IFIPs vision, or as a voluntary top-up for members.)
Affiliate Levels Family Alliance Friend Pledge
Donation amount $7,501 or More $2,501-$7,500 $1,001 - $2,500 $250 to $1,000 Conference or Regional Meeting Reduction 15% 10% 5%
Listing on our Website Yes Yes Yes Yes Receive monthly e-newsletter and member listserve Yes Yes Yes Yes
PAYMENT INFORMATION
Payments can be made by credit card, check, money orders or wires Checks and money orders should be made payable to International Funders for Indigenous Peoples Please email [email protected] for Bank Wire information
NOTE: Tax receipts will be provided for sponsorships and not for memberships if members are a 501(c)3 organization.
ENCLOSED PLEASE NOTE MY FORM OF PAYMENT
Check Money Order Wire Visa MasterCard American Express
Affiliate Membership Application 2
DONATION TOTAL
Name (of Cardholder) ______________________________________________________________
Card #_____________________________________________________________________________
Expiration Date ____________________________________________ Security Code __________
Signature (of Cardholder)____________________________________________________________
Telephone # (of Card holder) _________________________________________________________
PLEASE SEND FORM AND CHECKS TO:
International Funders for Indigenous Peoples PO Box 29184, San Francisco, CA 94129 T: (415) 580-7982 F: (415) 580-7983
Email: [email protected] Web: www.internationalfunders.org
Please Visit Us Online!
www.facebook.com/IFIPphilanthropy @IFIP IFIP
Visit us on the web at http://www.internationalfunders.org
AFFILIATE OPPORTUNITIESPAYMENT INFORMATIONPlease Visit Us Online!
What regions or countries do you work in: DONATION TOTAL: Name of Cardholder: Expiration Date: Security Code: Telephone of Card holder: Full Name of Organization: Contact Person: Address: City: State: Zip Code: Country: Telephone: Fax: Email: Website: Year Founded: Yearly Assets: Yearly Grant Level: % of Funds to Indigenous: What is the focus of your support or work with Indigenous communities: What do you most want to get out of being an affiliate of IFIP: What do you hope to contribute to the IFIP network and how is your mission in line with ours: How did you learn about IFIP?: Card #: Signature of Cardholder: Money Order: Wire: Visa: MasterCard: Amex: Check:
