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MEMBERSHIP APPLICATION

Please fill out the form below to become a member of CCSNYS. Once the registration is completed, you will be eligible to take advantage of all the member benefits and services.

Org Name: *
Address: *
City: *
State: *
Zip: *
Phone: *
Fax:
Email: *
Webpage:
County: *
Budget:
Full Time Staff:
Part Time Staff:
Pct Govt:
Member Type: *
Payment Method: *
Please tell us what you do, select up to 4 functions:
 Advocacy (Case/Client)  Advocacy (Policy/Lobbying)  Aging
 Animal Welfare  Art (Other)  Arts
 Arts (Visual)  Assisted Living Facility.  Association (State/Regional)
 Biomedical Research  Camp  Cemetery
 Child Care (Day/After School)  Child Rights (Child Welfare)  Child Welfare
 Civic Affairs  Clinical (Medical/Dental)  Community Action
 Community Center  County Fair  Credit Counseling
 Criminal Justice  Crisis Services  Cultural
 Disabilities  Domestic Violence  Economic Development
 Education (Community)  Education (Other)  Education (Primary/Secondary)
 Employment & Training  Environmental  Family Planning
 Food, Nutrition  Fundraising (Foundation/UW)  Gay/Lesbian Issues
 Grantmaking  Head Start  Health Care
 Health Prevention  Historical Society  HIV/AIDS
 Home Health  Homelessness  Horticulture
 Hospice  Hospital  Housing (Emergency/Trans/Perm)
 Infomation and Referral  International  Legal Services
 Library  Mental Health/Counseling  Museum
 Neighborhood/Rural Improvement  Planning/Technical Assistance  Poverty
 Recreation  Recreational/Sports  Religious
 Residential  Self-Help  Senior Center
 Social Justice  Substance/Alcohol Abuse  Technical Asstistance
 Trade Association  Volunteer Service  Volunteer Service
 Women's Services  Youth  Zoo
CCSNYS provides an ever-expanding variety of services for members, a few of which are listed below. These Services have specific eligibility criteria and/or fees. Please check here if you would like to receive more information about:
ORGANIZATIONAL/MANAGEMENT ASSISTANCE & TRAINING:
 Accounting Softw  Advocacy & Lobby  Automobile Insur
 BABN Seminar  Benefit Consult  BJs Membership
 Board Devel  Bookkeeping Serv  Bylaws
 ChooseYourCharit  Chronicle of Phi  Computer Purchas
 Computer Traing  Conference Calls  Consort. Devel
 Consult-Insuranc  Contract Mgmt  Crime Insurance
 D&O;  Dental  Discount Vision
 ED/CEO Search  Employee Consult  Entrepereneurial
 Financial Mgmt  Fiscal Agent Svc  Focus Grps, Surv
 Fund Devel  GiftWorks Softwr  Health
 Incorpor/Certifi  Legal Assistance  Life
 Marketing Resrch  Merger Planning  Needs Assessmt
 NY Wired Online  Office Suppiles  Other
 Other  Payroll  Personnel Consul
 Prgm Devel/Cons  Program Eval  Prop/Gen Liab
 Proposals  Resource Libr  Retirment
 Retreat Planning  Software/hardwar  Stat Disability
 Strategic Plan  Supp Disability  Team Building
 Telecomm mgmt  Unemployment Prg  Ventures Consult
 Workers Comp
Yes, I agree to the terms and agreement.
   

* required fields must be completed before submitting the form
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