Rural Coalition Organizational Member Form
Please complete this form to become an RC member or to renew your existing RC membership
Your Name:
First Name
Last Name
Your Email address:
example@example.com
What is your Organization's Name?:
When was your organization founded?
-
Month
-
Day
Year
Date
Mailing Address:
Parmanent Address
Present Address
City
State / Province
Postal / Zip Code
Main contact's phone number:
Your organization's logo
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Please add the names and email addresses of anyone else in your organization who should receive RC membership communications, including Member Call Invitations
Membership Options: Please select which payment tier is appropriate for your organization. We suggest the following framework:
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Basic Organizational Member
$
100.00
$100.00 annual membership fee for organizations with an annual operation budget of less than $10,000.
Organizational Member
$
250.00
$250 for organizations with an annual operating budget of $100,000 - $249,000.
Organizational membership
$
500.00
$500 for organizations with an annual operating budget of $250,000 - $749,000.
Organizational Membership
$
750.00
$700 for organizations with an annual operating budget of $750,000 - $999,000.
Organizational Membership
$
1,000.00
$1,000 for organizations with an annual operating budget of $1,000,000 or more.
Supporting Organizational Membership
$
1,500.00
Community Builder Organizational Membership
$
2,500.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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