Membership Application

Thank you for your interest in membership with the Public Lands Alliance. All new membership applications must be reviewed and approved. Once we receive your application and support materials, we will notify you of your approval.

Eligibility

To be eligible for membership with Public Lands Alliance, your nonprofit organization must have:

A mission that seeks to preserve our public lands and enrich those who use them
A formal agreement with one or more public lands agencies (or are in the process of obtaining)
A letter of determination stating that the organization is tax-exempt under section 501(c)(3) of the Internal Revenue Code (or an explanation that you are in the process of obtaining 501 (c)(3) status).

If you are joining Public Lands Alliance for the first time, you must provide us with verification of both your agreement with a public land agency and IRS designation.

PLEASE NOTE: we absolutely want to engage as many organizations as possible during this difficult time, and we also recognize that finances are a big stress for everyone right now, so once you've filled out the application, PLA will follow up and offer payment plan options if needed.

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* Membership Category

Public Lands Partner - For nonprofits that partner with specific parks, forests, refuges or other public land sites.

Emerging Public Lands Partner - For an organization that has not yet received its 501(c)(3) status or is in the process of obtaining an agency partnership agreement.

Nonprofit Ally - For a national organization that supports the public lands community but is not affiliated with a particular park, forest, refuge or other public land.

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* Primary Contact

Name

Title

Email Address

Phone Number (ext)

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* Organization Information

Organization

Address

City

State

Zip Code

Phone

Fax

Website

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* Mission Statement

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* Incorporation Information:

Year of Incorporation

State of Incorporation

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* Please List the Public Lands Sites You Serve

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* Agency Partners (Check all that apply)

Bureau of Land Management

Bureau of Reclamation

National Park Service

US Army Corps of Engineers

US Department of Agriculture - Forest Service

US Fish and Wildlife Service

National Oceanic Atmospheric Association

US Geological Survey

State Agencies

Municipal Agencies

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* Organizational Revenue Sources (check all that apply)

Retail Sales

Online Sales

License Plate Sales

Fee for Service Education Programs

Membership Program

Corporate Sponsors

Foundations/Grants

Individual Giving

Government Grants

Planned Giving

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* Organizational Impact Programs (check all that apply)

Onsite Fee-based Programs

Onsite Free Programs

School Programs

Teacher Training Programs

Distance/Online Learning Programs

Advocacy

Citizen Science

Internship Programs

Volunteer Programs

Product Development

Publishing/Wholesaling Program

Free Publications (guides, newspapers)

Land Acquisition

Resource Management

Restoration Management

Trail Building/Maintenance

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* If you operate a retail outlet, would you like to participate in the Reciprocal Discount Program?

Yes - we will extend a 10% discount to members from other member organizations.

Yes - we will extend a 15% discount to members from other member organizations.

Interested in learning more, send me additional information.

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* Organization Stakeholders: (If not applicable, type N/A. If zero, type 0)

Number of Board Members

Number of Full Time Staff

Number of Seasonal / Part-Time Staff

Number of Volunteers (other than board mbrs)

Number of Annual Volunteer Hours

Number of Members

Number of Donors