Applicant Information:

Full Name: (Last, First, MI)


Current Address: (Street, City, State, Zip)


Phone Number:


Email Address:


Referred By:

Company Information:

Name of Non-Profit:



Current Address: (Street, City, State, Zip)



Phone Number:



Email Address:



Area of Concentration:

Agreement:

By aligning in a networking/co-branding partnership with The Women Network (WN), your organization will be part of our rapidly growing movement. You will be part of the network of organizations working together unite, uplift and advance women of color. Together, we will benefit mutually as follows:

1. The Women Network (WN) shall provide opportunity for your organization to benefit by:

• Receiving recognition as an Community Alliance on our WN website with linkage.
• Posting approved announcements and articles on our WN website.
• Featuring your organizational print material at our major events, etc.
• Qualifying to partner with WN on select events.

• Providing, by request, a member of our WN team to serve as a Liaison.

2. Your organization shall provide opportunity for The Women Network (WN) to benefit by:

• Providing recognition as an Alliance Partner on group’s website with linkage.
• Posting approved WN announcements and articles on group’s website and other communications vehicles.
• Featuring The Women Network (WN) Speakers at appropriate events.
• Qualifying to partner on select events.
• Appointing a delegate to attend a Community Development Meetings.

3. Term and Termination:

The Partnership shall have an initial term of one year and shall be renewed automatically for one-year terms; except that either party may terminate this Alliance at any time with or without cause upon thirty (30) days prior written notice to the other party.

Agreement and Signature

By submitting this application, I affirm that facts set forth in it are true and complete. I understand that if I am accepted as a speaker, any false statements, omissions, or other misrepresentations made by me on this application may result in a rejection or immediate dismissal.

Full Name:

Inital:

Date (mm/dd/yy):

Our Policy : It is the policy of the Women Network to provide equal opportunities without regards to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in The Women Network!!!