U.S. Programs Membership Application Form
Organizational Profile
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Programs (Choose all that apply)
AdvocacyCapacity BuildingChildren of Prisoners
Disaster ResponseEarly Childhood DevelopmentEconomic Development
EducationFoster CareHealth services
HomelessHousingImmigrant-Refugee Services
Leadership DevelopmentRecreationRe-Entry Programs
Spiritual DevelopmentSpecial Need childrenSenior Care
Violence/Crime PreventionYouth DevelopmentYouth Mentoring
*What is your primary program focus?
Beneficiaries
* How many individuals are served by your organization yearly?
    Children  

    Adults  

* How many individual families are served by your organization yearly?
   
Please estimate the breakdown of your program beneficiaries by:
*Age:
0-5%
6-12%
13-18%
19-65%
66+%
Total0%
*Ethnicity:
African American%
Asian%
Caucasian%
Latino%
Native American%
Pacific Islander%
Other%
Total0%
*Gender:
Female%
Male%
Total0%
*Income:
Percentage of your program beneficiaries considered low income%
About Your Organization
*Briefly state the mission of your organization:
Youth Empowerment and Advocacy
World Vision seeks to support community transformation by equipping and inspiring young people and adults through dynamic initiatives that educate, empower, and foster advocacy.

*Is your organization interested in partnering with World Vision to equip youth for civic engagement and advocacy?
    Yes No

Training and Capacity Development
World Vision seeks to support community transformation by equipping organizations and individuals to better impact the well being of children.

*Is your organization interested in participating in training and capacity building offered by or convened by World Vision?

    Yes No

Product Resources
*Are you interested in a Storehouse subscription ($300 fee) to receive donated product from World Vision?
    Yes No

Form Completed By
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