The New York Council of Nonprofits, Inc.

(NYCON)

2011 Association Membership Application

Step 1. Check off appropriate Membership Dues Less than 25 Members 25-99 Members: 100-499 Members: Step 2. Tell us who you are.
Organization: Executive Director/CEO: Address
(City, State, Zip):

$800 $1,350 $1,900

500-999 Members: Over 1,000 Members:

$2,750 Please Inquire

www.nycon.org

Phone: E-mail Address: Website: County (Located in): # of Employees (FTE): # of Board Members:

Employer ID #:

THE NEW YORK COUNCIL OF NONPROFITS, INC.

NYCON
(Main Office)

Year Incorporated: Current Operating Budget: % Budget from Government:

Secondary Staff Contact Name & Title:

MENANDS
272 Broadway Albany, NY 12204 1.800.515.5012(p) 518.434.0392 (f)

Secondary Staff Email: Board President Name: Board President Email: How did you hear about NYCON? ___ Another nonprofit ___Workshop ___Online ___Other

REGIONAL OFFICES
BUFFALO
Ellicot Square Building 295 Main Street Buffalo, NY (716) 241-5010 (p)

Step 3. Tell us what your members do.

Advocacy (Case/Client) Advocacy (Policy/Lobbying) Aging Animal Welfare Art (Performing) Art (Visual) Art (Other) Assisted Living Facility Association (Business Improvement, Chamber, Homeowners, etc.) Association (State, Regional, etc.) Camp Cemetery Child Care (Day/After-School) Child Rights/Social Justice Child Welfare Civic Affairs Clinic (Medical or Dental) Community Action Program Community Center Community Education County Fair Credit Counseling0 Criminal Justice Crisis Services Cultural Disabilities Domestic Violence Economic Development Education (Primary/Secondary) Education (Other) Employment & Training Environmental Family Planning Food/Nutritional Gay/Lesbian Services/Issues Grantmaker Head Start Health Prevention/Research Historical Society HIV/AIDS Home Health Care Homelessness Horticulture Hospice Hospital Housing (Emergency/Transition) Housing (Permanent) Information & Referral International Relief/Services Legal Library Mental Health/Counseling Museum Neighborhood/Rural Improvement Planning/Technical Assistance/M.S.O. Poverty Recreation/Sports Religious Residential Care Self-Help Services Senior Center Substance/Alcohol Abuse Trade Association Volunteer Services Womens Services Youth Zoo

NEW YORK CITY

305 Seventh Avenue (27th Street) New York, NY 10001 212.924.6744 (p)

ONEONTA
224 Alumni Hall, SUNY Oneonta Oneonta, NY 13820 607.436.3124 (p) 604.436.2760 (f)

POUGHKEEPSIE
85 Cannon Street Poughkeepsie, NY 12601 845.454.5062 (p) 845.454.6032 (f)

2011 Association Membership Application (page 2)

Step 4. Tell us what your members need!
Group Purchasing Organizational/Management BJs Membership Assistance & Training Chronicle of Philanthropy Accounting Software Conference Call Services Advocacy & Lobbying issues Composite Bonding Board Development Program (Capitol Budget Development Improvements) By-laws Consultation-Insurance Development Review Benefits Employee Compensation Dental Insurance Consultation or Evaluation Directors & Officers Financial Management Liability Insurance Assistance Discount Fiscal Agent Services Software/Hardware Fund Development (Capital Discount Vision Care Campaigns) e-Learning Coursework Fund Development (General) Fund Development/Donor Incorporation/Certificate Mgmt Software Amendment Health Insurance IRS forms 990, 990T, CHAR Life Insurance 497, or NYSCFR Payroll Services Legal Assistance Property/General/Transp Merger Planning/Strategic ortation/ Professional Alliances Liability Personnel Policies & Retirement Benefits Employment Practices Staples Office Supplies Proposal Development Statutory Disability Retreat Planning & Benefits Facilitation Stanford Social Innovative Strategic Planning Review Team Building (staff and/or Supplemental Short/Longboard) Training Series Schedule Term Disability Technology Idealware Technology - NTEN Unemployment Program Web Conferencing Community Planning, Research & Evaluation Consortium Development or Contract Management Focus Group & Survey Research Marketing Donor Research Needs Assessment Program Development Consultation Program Evaluation Proposal Review & Consultation
All membership applications are subject to approval by the New York Council of Nonprofits, Inc.(NYCON). Membership in NYCON does not indicate, or otherwise imply endorsement or support by NYCON for the operation, mission or activities of any member organization. Members are free to state their membership affiliation with the NYCON in annual reports, brochures or proposals as long as the affiliation is not presented in a way that implies endorsement by NYCON of the organization or its activities.

www.nycon.org

THE NEW YORK COUNCIL OF NONPROFITS, INC.

NYCON
(Main Office)

MENANDS
272 Broadway Albany, NY 12204 1.800.515.5012(p) 518.434.0392 (f)

REGIONAL OFFICES
BUFFALO
Ellicot Square Building 295 Main Street Buffalo, NY (716) 241-5010 (p)

Step 5. Please return the following with your completed application:

A list of your nonprofit 501(c)3 members for which you are applying for NYCON membership on behalf of.
This list should include a primary contact (Executive Director), mailing address, number of employees (if available) email address and phone number. Please return all membership materials to our main office in Albany, NY.

NEW YORK CITY

305 Seventh Avenue (27th Street) New York, NY 10001 212.924.6744 (p)

**Please Read & Sign**

Organization Name:
Supports the mission and objectives of the New York Council of Nonprofits, Inc. (NYCON) a 501(C) nonprofit; agrees to be a voting member of NYCON and cooperative with other members in furthering the purposes and activities of NYCON; and hereby applies for membership on the basis of NYCON charitable purposes.

ONEONTA
224 Alumni Hall, SUNY Oneonta Oneonta, NY 13820 607.436.3124 (p) 604.436.2760 (f)

POUGHKEEPSIE
85 Cannon Street Poughkeepsie, NY 12601 845.454.5062 (p) 845.454.6032 (f)

Authorized Signature: Title: