Form | CDH

Community Development Halton 2024 New or Renewing Membership Application Form

Membership Contact First Name

Membership Contact Last Name

Professional Title

Membership Contact Work Telephone Number with Extension

Membership Contact Email

Organization Name

Organization Address

Organization Main Telephone Number

Organization Website

Organization "X" (Twitter)

Organization Facebook

Organization Instagram

Executive Director/CEO/Founder Full Name

Executive Director/CEO/Founder Telephone Number

Executive Director/CEO/Founder Email Address

Does your organization have a designated volunteer director/manager/coordinator?

Yes, same as Membership Contact Name

Yes, different than Membership Contact Name

No

Unsure/Not applicable

If Volunteer Director/Manager/Coordinator is different than Membership contact, please indicate their name and email below for our records:

Organizational Type

Registered Charity

Incorporated nonprofit organization

Unincorporated nonprofit organization

Grassroots Community Group

Community Support Service (firefighters, police, paramedics, transportation, regional and municipal government)

Public Agency

Organizational Description (Briefly describe your organization's mission, vision, values, programs/services, and history)

Is the organization:

Totally volunteer led

Staff plus volunteers

Staff only

Other

Select up to five (5) sub-sectors within which your organization's work falls:

Organization provides programs and services in (select all which apply):

Volunteer Populations Engaged (select all which apply):

Volunteer Categories (select all which apply):

Episodic (i.e. events and festivals)

Programs (set-term/ongoing)

Leadership (Boards and committees)

Annual Operating Budget

CDH Annual Membership Fee - based on Annual Operating Budget (select one)

$60 (Less than $100,000)

$120 ($100,000 - $250,000)

$180 (More than $250,000)

Number of paid employees:

Number of active volunteers in last calendar year:

Number of active volunteers in current calendar year:

How can Community Development Halton best support you?

How did you hear about Community Development Halton's membership program?

Membership Purchase

Small Organization (Annual Budget less than $100,000)CA$60

Medium Organization (Annual Budget between $100,000 - $250,000)CA$120

Large Organization (Annual Budget greater than $250,000)CA$180