Carolinian Canada Coalition Group Member Application

Connect. Leverage. Grow.

Benefits of Group Membership

My Wild Green Home booth page
Native plant source registration
Year-round and mobile outreach opportunities
Special event invitations
Professional development and networking
Stewardship and in-kind resources
Big Picture Services

Click here to learn more about group or individual memberships

All membership benefits available on request

Looking to make a personal donation?
Make an individual or family membership donation here.

Note: As an administrative contact, you must create a user account. Enter your contact information below so that you can manage your organization's profile, payment and membership. Our network manager will be in contact with you to go over the details of your membership if needed. If you already have an account, log in now and then return to this form.

Carolinian Canada requires member approval by the Board of Directors, allows one vote per group member and requires two representatives who have the authority to vote on behalf of the group. One may or may not be the administrative contact. Please enter the name and email of two representatives in the notes section.

Membership and Contact Email

Note: The email address below should be your personal/work email address as the purchasing contact. This information is required so that we can keep track of who is making a purchase.

Your Organization's General Email address can be submitted in the Organization Details section.

Choose Your Group Member Level *

Super-Canopy – Visioning - $ 5,000.00

Super-Canopy - Leading - $ 2,500.00

Super-Canopy – Emerging - $ 1,000.00

Canopy - Collaborating - $ 500.00

Canopy – Participating - $ 250.00

Seedling Member - $ 100.00

Or, Set Your Own Level - $ 0.00

Heritage or subsidized member – contact info@carolinian.org to apply

Other contribution or sponsorship – describe in the notes below

Total Amount

Email Address *

Organization Details

Note: The email address below should be the email address for your organization.

Organization Name *

Organization Email *

Address

Address 2

Postal Code

City

Website

Invoicing

I would like to request an invoice for this year's membership

I would like to request a recurring invoice for this amount yearly

Please provide the name and email address of primary and secondary contacts for this membership, as well as any other notes you would like included in the membership file.

Contacts and Notes

Carolinian Canada lists the names of our supporters and participants on our website, in our annual report and other program materials. We do not sell or trade your personal details.

I wish to remain anonymous

Account

If you would like to create an account on this site, check the box below and enter a Username and Password. If you already have an account please login before completing this form.

Create an account?

Username

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

Group Representative

Please do not create a generic user account or generic contact person.

A personal Carolinian Canada user account is required for purchasing group membership. This helps us keep track of who purchased the membership, as well as your contact information as a contact within your organization.

First Name *

Last Name *

Work Phone and Extension

Members support the mandate of the organization. New members require board approval. You will be contacted if your membership is not approved.