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 or lapsed member. If you are looking to renew your current membership please contact Kirsten Lew at kirsten@socalgrantmakers.org.

Select membership type you are interested in:

Are you a consultant affiliated with an organization?

YesNo

Organization Name

ORGANIZATION INFORMATION

Funder Category

Funder Category (other)

EIN

Organization's Linked In URL

How did you hear about SCG? (check all that apply)

Another SCG member [name optional]	SCG staff person [name optional]
Attended an SCG conference	Attended a SCG non-conference program/event
Social Media [name optional]	Was a former SCG member
Email from SCG	Through Philanthropy California, Northern California Grantmakers, or Catalyst of San Diego & Imperial Counties
Other (describe)

Name of SCG Member: (how did you hear about SCG?)

Name of SCG staff person: (how did you hear about SCG?)

Social Media: (how did you hear about SCG?)

Other: (how did you hear about SCG?)

How does joining SCG align with your areas of interest? How do you envision SCG supporting your philanthropic development/growth/goals?

Billing Address

Street

City

State

Zip Code

Country

Primary Email Address

Website URL

Must start with https://www.

Phone

MAIN CONTACT

First Name

Last Name

Email

Title

Preferred Phone

Work Phone

Mobile Phone

Other Phone

MEMBERSHIP INFORMATION

Where is your organization headquartered?

Total Prior-Year Grants

• If organization is based in L.A. County, use total prior-year grants.

• If 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.
• If based outside of SCG’s 8-county region, use only regional giving within those 8 counties.

Total Prior-Year Grants

• If organization is based in L.A. County, use total prior-year grants.

• If 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.
• If based outside of SCG’s 8-county region, use only regional giving within those 8 counties.

Dues Amount

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.

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

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

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