Membership Application Form
Thank you for your interest in joining the SCG Community! Please review our membership policy including eligibility requirements and dues calculation prior to completing this form.
Please complete this form only if you are a new member. If you are looking to renew your membership please contact Barbara Dibs at barbara@socalgrantmakers.org.
Select membership type you are interested in:
Please select...
Philanthropic Grantmakers
Government Grantmakers
Philanthropic Consultants
Are you a consultant affiliated with an organization?
Yes
No
Organization Name
ORGANIZATION INFORMATION
Funder Category
Please select...
Community Foundation
Corporate Foundation/Contributions Program
Donor Advised Fund
Family Foundation
Giving Circle
Government Grantmaker
Grantmaking 501(c)4
Grantmaking Public Charity
Individual Grantmaker
Operating Foundation
Philanthropy Consultant
Venture Philanthropy
Private/Independent Foundation
Other
Funder Category (other)
EIN
Year Founded
Input year in format YYYY.
Organization Mission/Goal
Staff Size
1-4
5-9
10-19
20-49
50+
Funding Areas (select all that apply)
Aging & Older Adults
Arts & Culture
Child Welfare & Foster Care
Disability Inclusion
Disaster
Education
Effective Philanthropy
Environment
Equity & Racial Justice
Gender Equity
Health & Wellness
Housing & Homelessness
Immigration
Justice Reform
Public Policy & Government Relations & Civic Engagement
Veterans & Military Families
Workforce/Economic Development
Youth Development
Geographic Funding Areas (select all that apply)
Long Beach/South Bay
South Los Angeles
San Fernando Valley
San Gabriel Valley
Kern County
Los Angeles County
Orange County
Riverside County
San Bernardino County
San Luis Obispo County
Santa Barbara County
Ventura County
Billing Address
Street
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Country
Please select...
AF
AX
AL
DZ
AS
AD
AO
AI
AQ
AG
AR
AM
AW
AU
AT
AZ
BS
BH
BD
BB
BY
BE
BZ
BJ
BM
BT
BO
BQ
BA
BW
BV
BR
IO
BN
BG
BF
BI
KH
CM
CA
CV
KY
CF
TD
CL
CN
CX
CC
CO
KM
CG
CD
CK
CR
CI
HR
CU
CW
CY
CZ
DK
DJ
DM
DO
EC
EG
SV
GQ
ER
EE
ET
FK
FO
FJ
FI
FR
GF
PF
TF
GA
GM
GE
DE
GH
GI
GR
GL
GD
GP
GU
GT
GG
GN
GW
GY
HT
HM
VA
HN
HK
HU
IS
IN
ID
IR
IQ
IE
IM
IL
IT
JM
JP
JE
JO
KZ
KE
KI
KP
KR
KW
KG
LA
LV
LB
LS
LR
LY
LI
LT
LU
MO
MK
MG
MW
MY
MV
ML
MT
MH
MQ
MR
MU
YT
MX
FM
MD
MC
MN
ME
MS
MA
MZ
MM
NA
NR
NP
NL
NC
NZ
NI
NE
NG
NU
NF
MP
NO
OM
PK
PW
PS
PA
PG
PY
PE
PH
PN
PL
PT
PR
QA
RE
RO
RU
RW
BL
SH
KN
LC
MF
PM
VC
WS
SM
ST
SA
SN
RS
SC
SL
SG
SX
SK
SI
SB
SO
ZA
GS
SS
ES
LK
SD
SR
SJ
SZ
SE
CH
SY
TW
TJ
TZ
TH
TL
TG
TK
TO
TT
TN
TR
TM
TC
TV
UG
UA
AE
GB
US
UM
UY
UZ
VU
VE
VN
VG
VI
WF
EH
YE
ZM
ZW
Primary Email Address
Website URL
Must start with https://www.
Phone
MAIN CONTACT
First Name
Last Name
Email
Title
Preferred Phone
Please select...
Work
Mobile
Other
Work Phone
Mobile Phone
Other Phone
MEMBERSHIP INFORMATION
Where is your organization headquartered?
Please select...
Central Valley California
Kern County
Los Angeles County
Northern California
Orange County
Outside California
Outside the US
Riverside County
San Bernardino County
San Diego County
San Luis Obispo County
Santa Barbara County
Ventura County
Total Prior-Year Grants
• If organization is based in L.A. County, use total prior-year grants.
• I
f based in SCG’s 8-county region (Los Angeles, Kern, Orange, Riverside, San Bernardino, San Luis Obispo, Santa Barbara and Ventura Counties), but NOT in L.A. County, use total prior-year grants. A 33% discount will automatically be calculated.
• I
f based outside of SCG’s 8-county region, use only regional giving within those 8 counties.
Please select...
$25,000-49,999
$50,000-99,999
$100,000-249,999
$250,000-499,999
$500,000-999,999
$1,000,000-1,499,999
$1,500,000-1,999,999
$2,000,000-3,499,999
$3,500,000-4,999,999
$5,000,000-7,499,999
$7,500,000-9,999,999
$10,000,000-50,000,000
$50,000,000 and over
Total Prior-Year Grants
• If organization is based in L.A. County, use total prior-year grants.
• I
f based in SCG’s 8-county region (Los Angeles, Kern, Orange, Riverside, San Bernardino, San Luis Obispo, Santa Barbara and Ventura Counties), but NOT in L.A. County, use total prior-year grants. A 33% discount will automatically be calculated.
• I
f based outside of SCG’s 8-county region, use only regional giving within those 8 counties.
Please select...
$25,000-49,999
$50,000-99,999
$100,000-249,999
$250,000-499,999
$500,000-999,999
$1,000,000-1,499,999
$1,500,000-1,999,999
$2,000,000-3,499,999
$3,500,000-4,999,999
$5,000,000-7,499,999
$7,500,000-9,999,999
$10,000,000-50,000,000
$50,000,000 and over
Additional Contribution
While membership dues are a crucial part of funding our programs and services, our work today is far broader and deeper than dues alone can support. Additional support is optional but greatly appreciated.
Total Contribution to SCG
Dues for Consultants
Additional Contribution
Additional support is optional but greatly appreciated, since dues cover only one-third of the programs and services that SCG provides to members and the philanthropy sector as a whole.
Consultants Total Contribution to SCG
How would you like to pay?
Since SCG works virtually and mail is picked up every 2 weeks, we prefer payment by Wire Transfer or credit card link, whenever possible. If you select wire transfer below, a link to our banking info will be included in the invoice you will automatically receive when you click on SUBMIT.
Please select...
Pay by check
Link to Pay Securely Online
Wire Transfer
REFERENCES
Reference #1
Full Name
Title
Organization
Email
Phone
Website
Engagement Start Date
Engagement End Date
Description
Reference #2
Full Name
Title
Organization
Email
Phone
Website
Engagement Start Date
Engagement End Date
Description
Reference #3
Full Name
Title
Organization
Email
Phone
Website
Engagement Start Date
Engagement End Date
Description