MEMBERSHIP FORM _________________________________________________________________ GREEN OMAHA COALITION
Join Omaha’s growing green movement. The strength of the Green Omaha Coalition comes from the
support and involvement of talented, diverse, and passionate
individuals and organizations from throughout the community.
The mission of the Green Omaha
Coalition (GOC) is to promote a greener
Omaha through collaboration,
education and advocacy.
The GOC is an alliance of businesses,
government agencies, non-profit
organizations and individuals that have
a shared goal of creating a “Green
Omaha.”
Become a Green Omaha Coalition member today!
MEMBER INFORMATION
Please complete all fields below.
The GOC is incorporated as a non-profit
organization in the state of Nebraska.
We are recognized as a 501(c)(3)
charitable organization from the federal
government
Name(s):
Contact (orgs. only):
Mailing Address:
City, State, Zip:
Phone:
Email:
ANNUAL MEMBERSHIP CATEGORIES
• Membership in the Green Omaha Coalition is open to any interested individual or organization.
• Members will receive GOC communications and special invitations to events and activities.
INDIVIDUAL MEMEBERSHIPS
ORGANIZATIONAL MEMBERSHIPS
Individual - $15
Dual - $30
Household - $50
Patron - $100
This membership is:
new
Grassroots - $100 - $249
Contributor - $250 - $499
Supporter - $500 - $999
Sustainer - $1,000+
or
a renewal.
Memberships are for full 12 months.
NOTES: Any information provided to the GOC will not be sold or used for solicitation purposes. Your membership dues may be tax
deductible.
Make checks payable to the Green Omaha Coalition. Mail the completed form with your signed check to:
Green Omaha Coalition, P.O Box 31394, Omaha, NE 68131
MEMBER RECOGNIITON:
Contributions of $100 or more will be recognized in Green Omaha Coalition publications. If you would
prefer NOT to have your name listed in GOC publications and communications, please check this box.
FOR GOC MEMBERSHIP COMMITTEE USE ONLY: Payment received by: _________________________ Date received: __________________
Check number: __________________ Check amount: _________________