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

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

Affiliate acronym or common name

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

Guest Organization Name

Please enter your organization/company name if you selected Guest from the Philanos Affiliate drop down list above.

Affiliate/Organizational Title

Are you a board leader (ie Chair), a board director, a committee chair, or a committee member?

*Staff

Yes

No

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

Reason for Subscribing

How did you hear about Philanos?

Affiliate's Website

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