Membership Application

Thank you for your interest in joining Alameda County CAN!

Please answer the following questions as your application for membership (Applicants for full membership answer all questions; others answer questions 1-3, & 10):

Agency or Organization Name:

Contact:

Phone:

Email:

Website:

1. Mission Alignment: Please indicate how your mission and work aligns with Alameda County CAN.

2. Expectations: Please indicate your expectations of Alameda County CAN's work, and in what period of time you would like to see those expectations met.

3. Contribution: Please indicate how you believe your involvement would contribute to the work of Alameda County CAN,

and how will the efforts of Alameda County CAN contribute to your work?

4. Not-for profit: Please indicate you status as either a 501c3, public agency, or other not-for-profit agency.
501c3
public agency
other not-for-profit agency

5. Working commitment: Alameda County CAN members have monthly workgroup meetings in addition to monthly committee meetings. All members are expected to attend a majority of the workgroup meetings. Members are strongly encouraged to sit on a committee, contribute to CAN's projects, and work between meetings. While we strive for consistency in participation, in case of absence you are encouraged to send someone in your stead. Multiple staff from your organization are welcome to participate, however in decision-making matters, each organization has one vote.

Please indicate your interest and ability to make a working commitment to Alameda County CAN, including who from your organization will participate, what role they expect to play, and what committee they expect to participate in.

6. Principles regarding funding: Alameda County CAN members are committed to transparency regarding the funding of our work. We do not perform our work in order to be funded, we seek funding so that we can perform our work well. We are exploring options for joint funding, and it is expected that organizations will seek funds to make their involvement possible. Alameda County CAN members may be funded by task as necessary to complete the work. We adhere to three commitments:

1. We provide notice to the group when we seek funding for individual organizational participation, and

2. We solicit permission from the group for joint funding proposals.

3. When surveyed about fundraising opportunities for Alameda County CAN, members agree to disclose whether they are currently funded by, or actively pursuing funding from, that source.

Is your organization able to adhere to Alameda County CAN's funding principles?

Yes
No

7. Full disclosure of interests: Alameda County CAN members agree to ongoing disclosure of any organizational, personal, or professional interest that may conflict with Alameda County CAN's mission; compete with the work of Alameda CAN, or impact their judgment as members. Alameda County CAN members err on the side of disclosure.

Please disclose any competing interest or conflict that you may have at this time.

8. Partners: Do you or your organization currently partner with any Alameda County CAN Members on other projects or initiatives? If so, who?

9. Waiver: Alameda County CAN and its Members have mutually agreed to waive their respective rights to sue the other for any harm arising out of a Member's participation in the Network. Are you willing to agree to such a waiver?
Yes
No

10. Website Listing*: Does your organization wish to be listed on Alameda County CAN website?
Yes
No

* Please note that Alameda County CAN does not sell our membership list to third parties.

11. Other: Please add anything you think is relevant to your membership application

Thank you for your interest!