Sign Up – CORESSWC

MEMBERSHIP APPLICATION

A 501(c)3 Nonprofit Organization

VISION

Serve the community by supporting abused women and complimenting school's financial literacy curriculum for teens

MISSION

Connecting with one abused woman and one teen at a time to adapt strong measurable CORE values and disciplines

Participant Information
First Name
Last Name
Address
City
State
Zip Code
Country
Primary Phone Number
Email
Birthday (MM/DD)
Emergency Contact Name
Emergency Contact Number
Emergency Contact E-mail
Mailing List	do you want to receive our newsletter and occasional announcements?
Membership
membership type
# of hours
How did you hear about us?
committee interest
Skills
SPIRITUALITY & WELLNESS	What does "Spirituality" mean to you?
Skills
Affirmation	What does "Affirmation" mean to you and do you practice or are you interested in getting more information? It's OK if you don't, you can answer N/A at this time.
Giving Heart	What does "having a giving heart" mean to you?
Laws of Attraction	What does "The Law of Attraction" mean to you? If it does not have an immediate meaning to you at this time, it's OK
Individuals of Like Mind	What does the phrase 'Individuals of like mind mean to you?
Spiritual and Wellness Books	Do you have any spiritual awareness books you want to share?
Community Involvement	Did you in the past or do you currently belong to any non-profit groups? Please list
Membership Dues/Donations Membership Dues and donations are tax-deductible and assist in upholding our $8K Operations budget, thank you!
Quarterly	$30 by January 1, April 1, July 1, and October 1
Annually	($120 payable by January 1)
Bi-Annually	($60 by January 1 and July 1 respectfully)
Certification
Payment Method	By submitting this application I certify that mail can be delivered to the address on this application and it is my principal place of residence and commit and elect the following payment method for my dues
Good Standing Membership Compliance
Good Standing Agreement	By checking the 'Good Standing' checkbox I agree to suspension of my membership post 30 days past due, communication and all voting rights will be suspended until date of restoration (after account is brought current)
Application Submit Date

2.9% Paypal fee added (+.30) OR Donate via Zelle to [email protected]

MEMBERSHIP APPLICATION

VISION

MISSION

Participant Information

Membership

Skills

Membership Dues/Donations

Certification

Good Standing Membership Compliance