Membership Application

Membership in PRI Makers Network is available to eligible organizations who agree to uphold a Code of Conduct. To join, please 1) complete this application, 2) submit it electronically, 3) print your receipt (which you will receive via email), and 4) send a check for the appropriate dues amount. You will be notified of your member status and receive your membership password to access all member benefits. Questions? Contact PRI Makers Network at 206.443.8430 or via email.

Primary Contact

Information about the primary contact for the member organization.

Name: *

Title: *

Phone: *

Fax:

Email: *

Second Individual

Second individual in the member organization.

Name (2):

Title (2):

Phone (2):

Email (2):

Third Individual

Third individual in the member organization.

Name (3):

Title (3):

Phone (3):

Email (3):

Fourth Individual

Fourth individual in the member organization.

Name (4):

Title (4):

Phone (4):

Email (4):

Fifth Individual

Fifth individual in the member organization.

Name (5):

Title (5):

Phone (5):

Email (5):

Additional Individuals

If you would like to add additional contacts, please submit those names with title, phone number and email address under the "comments" section below.

Organization's Information

Information about the member organization.

Organization: *

Organization Type: *

Address: *

City: *

State: *

Zip Code: *

Country: *

Organization's Web Site:

Please answer these questions

(note: you do not have to be a current PRI funder in order to join the network.)

Program Description:

Describe the nature of your current or prospective PRI program.

Scope Geography: *

Geographical scope of organization's PRIs

Total Assets: *

Total assets of organization

Average Annual PRI Lending: *

Average annual PRI lending of organization

Other Program Priority Areas:

If you select "Other" above, please type in your priority areas.

Comments:

Membership Type: *

Please select your membership type and annual dues amount.

Membership Application

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