Interested New Members New Member Request for Admission Organization Name*Please give your organization’s nameName of Executive Director or Chief Officer* First Last Email* Contact Person's Name (If different from ED) First Last Contact Person's TitleContact Email Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Mission Statement*Please provide your organization’s mission statement or statement of purposeDescription of Programs and Activities*Upload a description of your organization’s programs and activitiesMax. file size: 50 MB. How does your organization work to protect and enhance the natural environment?*Provide a brief description for the ways your organization achieves thisWhat geographic area do you serve, and how are those services provided?*Are you a Membership organization?* Yes No How large is your membership?What constituencies do you serve?*Provide a brief description of all constituencies that your works servesIs your organization a local chapter or affiliate of a NC or National organization?* Yes No Does your organization maintain a separate accounting system with a separate audit? Yes No What will your organization offer as a Member of the EarthShare NC coalition?*examples could be volunteer opportunities, corporate contacts, increased visibility, etc.Provide any additional information you feel would be relevant Drop files here or Select files Max. file size: 50 MB. Part II: Organizational DocumentsArticles of Incorporation*Upload a copy of your organization’s articles of incorporationMax. file size: 50 MB. Federal and North Carolina Tax Exemption determination letters*Upload a copy of both determinations from the federal government and NC. Drop files here or Select files Max. file size: 50 MB. Most Recent Annual Report*Upload a copy of your organization’s most recent Annual Report. (It does not have to be an official or public Annual Report, but should show organizational breakout of revenue and expenses and include references to programmatic workMax. file size: 50 MB. Current NC Solicitation License*Please upload a copy of your NC Solicitation license that will be current as of March 15th 2023. pdf versions onlyMax. file size: 50 MB. Current Board Member List**List must include addresses and end date of each member’s term. pdf version onlyMax. file size: 50 MB. Upload: Annual Audit (No earlier than 6/30/21)**Must include the auditor’s report with their signature and identifying them as a CPA. The audit must use the accrual basis of accounting and must meet both GAAS and GAAP standards. pdf version onlyMax. file size: 50 MB. Upload: IRS 990 Form SIGNED by Director of the organization*PLEASE READ ALL NOTES: *990 must use the accrual basis of accounting. ALL schedules and attachments MUST be included. If you submitted your 990 electronically o the IRS you MUST sign the 990 on the first page or include the signed Electronic Submission Form. **Signatures by CPA or outside accountant will not be accpeted. ***Submitting the 990EZ form will not be accepted Drop files here or Select files Max. file size: 50 MB. Board Chair Signed Certifications Document*Please upload a completed copy of the certifications document approved by your Board Chair, signed and dated. (This would have been provided to you via email)Max. file size: 50 MB.