| Our Giving Community Dues Form |
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| Your Organization's Name |
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| Our Giving Community Federation and Fund Member Dues
Structure |
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$400 (Annual campaign Revenue: $0 - $149,999) |
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$800 (Annual campaign Revenue: $150,000 - $499,999) |
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$950 (Annual campaign Revenue: $500,000 - $999,999) |
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$1,250 (Annual campaign Revenue: $1,000,000 - $1,999,999) |
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$1,750 (Annual campaign Revenue: $2,000,000 and above) |
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| Individual Nonprofit or Employer Member Dues Structure |
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$100 (Annual campaign Revenue: $0 - $24,999) |
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$250 (Annual campaign Revenue: $25,000 - $149,999) |
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$500 (Annual campaign Revenue: $150,000 and above) |
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Payment and billing |
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| Full name as it appears on the credit card |
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| Billing Address: |
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| City, State and Zip Code |
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Email address
Confirmation email and receipt will be sent to this address
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| Credit card number (Visa/MC, Amex, Disc) |
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| Credit card security code |
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| Expiration date (mm/yy) |
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