ALICE® Council of Partners Membership Application All organizations or businesses seeking to join the ALICE® Council OF Partners through United Way of Pennsylvania must provide the following information and attachments. Please reach out to Kim Amsler, kamsler@uwp.org if you have any questions. Which membership level is your organization applying for?(Required) $5,000/year: Statewide or regional for-profit organization membership which includes providing access to the member benefits for all of their local members or chapters. $2,500/year: Statewide or regional nonprofit organization membership which includes providing access to the member benefits for all of their local members or chapters. $1,000/year: Statewide or regional nonprofit or for-profit organizations with annual budgets over $300,000 $500/year: Statewide or regional nonprofit or for-profit organizations with annual budgets of $300,000 or less. $250/year: Local nonprofit organizations and small businesses can join the ALICE Council independently pending the receipt of a positive recommendation from their local United Way. Organization/Business Name(Required) Organization Address(Required) 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 Organization Website Organization Social Media linksInstagramFacebookLinkedInTwitter Add RemoveExecutive Director / CEO Name(Required) First Last Executive Director / CEO Email(Required) Enter Email Confirm Email Primary Contact Name(Required) First Last Primary Contact Email(Required) Enter Email Confirm Email Primary Contact Phone Number(Required)Would you like to receive Public Policy updates and engagement as part of your ALICE Council of Partners Membership Benefits? Yes NO Please upload your logo or email it to info@uwp.org.Accepted file types: jpg, jpeg, png, gif.Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Total How would you like to pay?(Required) Check Credit Card Credit Card