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CAC2 Membership: Supporting Organization

New Supporting Organization Membership
Organization Member: To be eligible for membership as an Organization Member, an entity must be (a) a childhood cancer organization or coalition, or (b) a nonprofit, tax-exempt organization with a primary interest in childhood cancer issues. Supporting Member: Non-profit and for-profit organization that does not qualify as an Organization Member shall be eligible for membership as a Supporting Member.

Organization and Supporting member annual dues for CAC2 are determined by the annual gross revenues from the organization’s most recent fiscal year (please consult Page 1 of your latest Form 990 or 990-PF).
Total Amount
CAC2 Supporting Organization
 
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Organization Address
Organization Information
Please be as specific as possible
The IRS designation of the organization, if applies
Please indicate the geographic area(s) that you serve
Focus Areas:
Please indicate the percentage(s) that best describes the focus your organization’s activities. Estimates are fine and should total to 100%
Identify the "other" if you have indicated a percentage of an "other" focus.
Annual Revenue and Program Spending:
Please provide the following in $ or local currency for the most recent fiscal year.
Annual gross revenues from the organization’s most recent fiscal year (please consult Page 1 of your latest Form 990 or 990-PF).
Impact and Reach:
Please provide estimates for the following items that communicate your organization’s impact and reach for the most recent year for which your organization tracks the information.
Please answer however your organization communicates this.
Please answer however your organization communicates this.
for all social media apps for your org (e.g., Facebook, Twitter, YouTube)
If you track media exposure, please answer this in whatever manner your organization reports it.
Associate Members can participate in all CAC2 activities and there is no extra charge to a Member Organization for Associate Members.
Please include names and emails so that your Associate Members can receive all CAC2 communications
Please describe any collaborative effort(s) in which your organization participates in the pediatric cancer community – either within CAC2 and/or outside of CAC2
How did you learn about CAC2?
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Your contact information
 
Credit Card Information
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Billing Name and Address
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