Nonprofit Registration Form
	
STEP 1: ORGANIZATIONAL INFORMATION	
Organization's Name:	EIN #:__________________________________
Business Address:
City:	State:	Zip Code: _________
Phone:	   Fax:	Website:	
Contact's Name:     	      	
Contact's Title:	Contact's E-mail:___________________________________
Chief Executive's Name:	
Chief Executive's Title:	Email:_______________________________________
Annual Operating Budget: $	Number of Clients Served Per Month:
Mission Statement (Limit 20 words. Attach separate sheet if necessary):	____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Organization's NTEE Code(s) / Service Area(s) (Check all that apply)
Please list below the applicable National Taxonomy of Exempt Entities (NTEE) codes that most appropriately describe the services your organization provides to the community. You can find a full list of NTEE codes at:
http://nct5.urban.org/classification/NTEE.cfm
Geographic Scope of Services must be within your local community only (50 mile radius). 
  
Does your organization operate a thrift store or a Habitat for Humanity Restore? ___ Yes ___ No
 
Products Needed (Check all that apply)
___ Building Materials   ___ Children's Items   ___ Personal Care Products  ___ Clothing and Accessories
___ Home Goods ___ Computer Software ___ Office Products  ___ Other
	
How did you hear about Zion World Wide Mission Inc? (Check all that apply)
__Company Web site __ Conference __ News Media __ Nonprofit Referral 
__ Company referral __ Internet research __Nonprofit Web site   ___ other	
Referred by:_______________________________________________________________

Review the registration requirements carefully. Your organization must submit all required documentation with a completed registration form. Your membership will be denied if this application is not completed or approved, or your organization does not meet minimum qualifications; 50% of the registration fees will be nonrefundable due to processing costs. Please note: Registration fees will not be refunded to organizations canceling their partnership after being approved.

Registration Type     One-Year Registration Fee   Required Documentation	
Friend	FREE	• Completed Registration Application • S01(c)(3) Certification from Internal Revenue Service Additional info needed prior to first product request:
• Most Recent 990 Form or Audited Financial Statement, • List of Board of Directors • General Program Materials (i.e. brochure of services)	including Auditor's Opinion	
Nonprofit Organization	$75	• Completed Registration Application • 501(c)(3) Certification from Internal Revenue Service Additional info needed prior to first product request: • Most Recent 990 Form or Audited Financial Statement, including Auditor's Opinion • List of Board of Directors • General Program Materials (I.e. brochure of services) • Registration fee payment fay check, credit card, or money order	

STEP 3: REGISTRATION FEES AND REQUIREMENTS Type of Registration (Check One):

Membership Valid for One Year

Nonprofit Organization/U.S. Indian Reservation	D $150
Friend (limited access to Zion World Wide Mission)	D $0
For Registration Fee Payment by Credit Card Only:. (Friends ignore this.)
Charge Payment to:    D MasterCard       D Visa    D Discover/Novus       D American Express
Amount to be Charged: $	Credit Card Billing Zip/Postal Code:	
Credit Card Number:	*	    Credit Card Expiration Date:	
Name on Credit Card:	
Authorized Signature:
For Payment by Check: Mail completed application to:
Zion World Wide Mission Inc. 108 Shaw St. Greenville SC 29609
Check/Money Order Number:	Amount of Check/Money Order: $___________________