PHILANOS - Member Subscribe

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Provide us with your contact information in the subscription form below to receive our email communications and stay connected.

* Mandatory fields

*First name

*Last name

*Preferred first name

First Name, Nickname, what do you like to be called?

*Email

MANDATORY FIELD for logon capability. This is your primary email and will become a member's user ID.

*Philanos Affiliate

If your organization is not listed please enter the complete name in the "Other Organization" field below.

Affiliate acronym or common name

I.E. IWCF" for Idaho Women's Charitable Foundation or "Impact Philly" for Impact100 Philadelphia

Guest Organization name

Please enter your organization's name if it does not appear in the Catalist Affiliate drop down list above.

*Preferred Phone

Enter mobile or your preferred number.

Organizational Title

Are you a board member, ie Chair, Treasurer, Director, Committee chair?

Affiliate's Website

*Staff

Yes

Indicate YES if you are a paid staff person for your organization.

Reason for Subscribing

How did you hear about Philanos?

* Code

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