Affiliate Membership Application

Organization or Primary Contact Email

Serves as the voting Member for your organization's membership and is the main representative in the Member Directory. They may also serve as the billing liaison. Please include the primary contact's name, title, email address, and phone number below.

Has privileges to manage the organization's Member Directory profile, including updating the organization profile and affiliated contacts. Please include the administrative contact's name, title, email address, and phone number below or leave it blank if the information is the same as the primary contact.

Receives annual dues renewal packets. Please include the billing contact's name, title, email address, and phone number below or leave it blank if the information is the same as the primary or administrative contact. 

Please include agency names, addresses, and grant/donation/sponsorship amounts. 

Annual Affiliate Membership Dues: $250

Dues are based on the calendar year and may be prorated for members joining during the course of the year. Once your membership application is approved, you will receive an invoice for the appropriate dues amount. Upon receipt of dues, Member benefits are available.

Optional additional grant funding you would like to provide, beyond annual dues, to support PhilMO. Philanthropy Missouri is a 501(c)(3) nonprofit, EIN: 43-0953940