Paterson Alliance

301 Main Street, Center City Mall, 3rd Level * Paterson, New Jersey 07505

Facebook: Paterson Alliance * Twitter: Vibrant Paterson * LinkedIn: Paterson Alliance

NonProfit Member Dues:

$50 - Budget up to $99,999

$100 - Budget $100,000 to $499,999

$200 - Budget $500,000 to $999,000

$350 - Budget over $1,000,000

Other Member Dues:

$100 - Individual Members

$1,000 - Corporate Members

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MEMBERSHIP APPLICATION

APPLICANT INFORMATION

Organization Name*

EIN/SSN: Phone:* Fax:

Current Address:*

City:* State:* ZIP Code:*

Website: Facebook: Twitter:

DESIGNATED REPRESENTATIVE INFORMATION

Name*

Title: Cell Number:

Phone:* Fax: Email:*

ALTERNATE DESIGNEE INFORMATION

Name

Title: Cell Number:

Phone: Fax: Email:

Thank you for your interest in joining the Paterson Alliance. We will review your application and respond to you shortly.

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