www.DenverSeniorCoalitions.org East, Northwest, South & Southwest Chapters Use this Application for 1, 2 or 3 people joining ALL Denver Coalitions for 2017 with one check. If you are paying with a credit card – use the online application. 2017 DUES FOR JOINING ALL 4 DENVER SENIOR COALITIONS • $225 One Person Membership, One Company, Join THREE Coalitions & 4th Coalition is Free $56.25 per each of 4 coalitions = $225.00) – Cost per month, per person, per meeting = $6.25 ($225 divided by 36 meetings = $6.25 per meeting per person) • $300 Two Person Membership, One Company, Join THREE Coalitions & 4th Coalition is Free $75 per each of 4 coalitions = $300.00) – Cost per month, per person, per meeting = $8.33 • ($300 divided by 36 meetings = $8.33 per meeting; Divided by 2 people attending each meeting = $4.16 per person) th $375 Three Person Membership, One Company, Join THREE Coalitions & 4 Coalition is Free $93.75 per each of 4 coalitions = $375.00) – Cost per month, per person, per meeting = $3.47 ($375 divided by 36 meetings = $10.41 per meeting; Divided by 3 people attending each meeting = $3.47 per person) Make checks payable to: Denver Senior Coalitions Note that you will be added to the Membership List for all 4 coalitions and given access to all 4 membership lists. You will receive a “Welcome email” with the passwords to the 4 membership lists. • Mail Application with Check to: Patty McIlvaine P.O. Box 112 Pine, CO 80470 Contact Membership Officers with Questions Debra Kirsten - [email protected] - 720-933-9404 Lee McCue – [email protected] - 303-859-0198 --------------------------------------------------------------------------------------------This Membership Application has cells. Save the Application to your computer with your company name. Type in the information and then mail the form to Patty McIlvaine. 1. If paying with check then MAIL the Application with your check to Patty. 2. You mail also bring your application & check to a meeting. 3. If paying by credit card then use the online system. Company Name: Person filling out Form: Main Phone: Cell: Fax: Address, City, State, Zip: Website: Company description (one sentence): 2017 Membership Application www.DenverSeniorCoalitions.org 1 www.DenverSeniorCoalitions.org I paid by: Check on this Date: Name on Check: Your Phone Number: Individuals who will be attending meetings: $225 One Person Membership per Coalition, One Company, ALL FOUR COALITIONS Your company will have one person listed on the member list for each of the 4 coalitions (for a total of 4 people, 1 per each of the 4 coalitions). Does not have to be the same person. You can assign different people to each of the coalitions, though only one person can attend individual meetings, receive email notifications and have his/her contact info on the member list(s). If the person assigned to the coalition cannot attend the meeting, a substitute may attend. $300 Two Person Membership per Coalition, One Company, ALL FOUR COALITIONS Your company will have two people listed on the member list for each of the 4 coalitions (for a total of 8 people; 2 per each of the 4 coalitions). You can assign different people to each of the coalitions, though only 2 people can attend individual meetings, receive email notifications and have their contact info on the member list(s). If a person assigned to the coalition cannot attend the meeting, a substitute may attend. $375 Three Person Membership per Coalition, One Company, ALL FOUR COALITIONS Your company will have three people listed on the member list for each of the 4 coalitions (for a total of 12 people; 3 per each of 4 coalitions). You can assign different people to each of the coalitions (for a total of 9 people), though only 3 people can attend individual meetings, receive email notifications and have their contact info on the member list(s). If a person assigned to the coalition cannot attend the meeting, a substitute may attend. Please indicate which coalition a person should be assigned to as his/her primary coalition for member list and email notifications. Reminder: $225 - One Person Membership per Coalition could have up to 4 people listed (1 per coalition) Reminder: $300 - Two Person Membership per Coalition could have up to 8 people listed (2 per coalition) Reminder: $375 - Three Person Membership per Coalition could have up to 12 people listed (3 per coalition) Fill out the appropriate number of rows: 4, 8, or 12 Names QUESTIONS? Title Cell Email Coalition(s) Assigned East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW East NW S SW Contact Coalition Membership Officers with Questions Debra Kirsten - [email protected] or Lee McCue – [email protected] 2017 Membership Application www.DenverSeniorCoalitions.org 2 www.DenverSeniorCoalitions.org East, Northwest, South & Southwest Chapters 2017 DUES INVOICE FOR JOINING THE 4 (FOUR) DENVER SENIOR COALITIONS Join 3 Coalitions and the 4th Coalition is Complimentary Date: _________________________________ Invoice To: _________________________________ Address: _________________________________ Contact & Phone: _________________________________ For: 2017 DUES FOR JOINING ALL 4 DENVER SENIOR COALITIONS East Chapter Northwest Chapter South Chapter Southwest Chapter Dues: • Dues are for the 2017 calendar year for all 3 coalitions & the 4th Coalition is complimentary (Annual January through December dues are not prorated) $225 One Person Membership, One Company, Join THREE Coalitions & 4th Coalition is Free $56.25 per each of 4 coalitions = $225.00) – Cost per month, per person, per meeting = $6.25 ($225 divided by 36 meetings = $6.25 per meeting per person) • $300 Two Person Membership, One Company, Join THREE Coalitions & 4th Coalition is Free $75 per each of 4 coalitions = $300.00) – Cost per month, per person, per meeting = $8.33 ($300 divided by 36 meetings = $8.33 per meeting; Divided by 2 people attending each meeting = $4.16 per person) • $375 Three Person Membership, One Company, Join THREE Coalitions & 4th Coalition is Free $93.75 per each of 4 coalitions = $375.00) – Cost per month, per person, per meeting = $3.47 ($375 divided by 36 meetings = $10.41 per meeting; Divided by 3 people attending each meeting = $3.47 per person) Make checks payable to: Denver Senior Coalitions Your check supports the Charitable Work we do through the Joint Coalition Assistance Fund • Note that you will be added to the Membership Lists of all coalitions and given access to all 4 membership lists. You will receive a welcome email. • Mail Application with Check to (Or you mail also bring your application & check to a meeting): Patty McIlvaine P.O. Box 112 Pine, CO 80470 • Have questions about Membership? Ask a Membership Officer! Debra Kirsten - [email protected] - 720-933-9404 Lee McCue – [email protected] - 303-859-0198 2017 Membership Application www.DenverSeniorCoalitions.org 3 www.DenverSeniorCoalitions.org East, Northwest, South & Southwest Chapters 2017 DUES RECEIPT FOR JOINING ALL DENVER SENIOR COALITIONS Received from: _________________________________ Date Paid: _________________________________ TOTAL AMOUNT PAID: _________________________________ Thank you for joining all 4 Chapters of the Denver Senior Coalitions! Have questions about Membership? Ask a Membership Officer! Debra Kirsten - [email protected] - 720-933-9404 Lee McCue – [email protected] - 303-859-0198 More Information ▪ East Chapter Meetings are held the 3rd Wednesday in Jan, Feb, April, May, July, Aug, Oct & Nov 9:30 - 11:30 AM ▪ Northwest Chapter Meetings are held the 2nd Wednesday in Jan, Feb, April, May, July, Aug, Oct & Nov 9:30 - 11:30 AM ▪ Southwest Chapter Meetings are held the 2nd Thursday in Jan, Feb, April, May, July, Aug, Oct & Nov 9:30 - 11:00 AM ▪ Southwest Chapter Meetings are held the 4th Tuesday in Jan, Feb, April, May, July, Aug, Oct & Nov 9:30 - 11:30 AM ▪ Joint Coalition Meetings Joint Coalition Meetings are held four times a year in March, June, September and December and the day of the month can vary. ▪ The December Joint Coalition Meeting is a Holiday gathering. ▪ Joint Coalition Assistance Fund (JCAF) Your check supports the charitable work we do through this fund. Be sure to check out how to use the Joint Coalition Assistance Fund (JCAF) to help seniors in need – look for the JCAF tab on www.DenverSeniorCoalitions.org ▪ Hosting a Meeting If you have room to host a meeting and the resources to serve a continental breakfast contact a Location Officer to check availability and what is required. If you are not a senior housing location, you can rent a location to host a meeting and arrange for other coalition members to be your co-hosts. ▪ Programs and Speakers Contact a Program Coordinator with ideas for speakers. ▪ Events, eNewsletters & Sponsorships Check out the event calendar and eNewsletter for Professionals serving seniors posted on www.DenverSeniorCoalitions.org. You can submit both professional and consumer events through the Denver Senior Coalition website. Professional events are posted on www.DenverSeniorCoalitions.org and events for consumers (seniors) are posted on www.SeniorsResourceGuide.com/Denver ▪ More Membership Benefits For more information about Membership Benefits visit the About page on the coalition website. ▪ Consider Volunteering as an Officer Elections for officers are typically held in the fall – contact a President for information about positions available and what is required. ▪ Questions about the www.DenverSeniorCoalitions.org website? SeniorsResourceGuide.com built and donated the website to the coalitions and they maintain the events web page, website content, coalition forms and send out eNewsletters. For questions about the website contact Karin Hall at Seniors Resource Guide.com. She can be reached at 303-794-0799 or at [email protected]. File Name: join_all_3_coalitions_application_2017.docx Form updated - 1-2-17 2017 Membership Application www.DenverSeniorCoalitions.org 4
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