Membership Enrollment Form Name First Last Organization Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone (work)Phone (cell)Membership Category Organizational Friend Hardship Introductory Most members fall under the Organizational or Friend categories. Before selecting the Hardship or Introductory category, please contact the director at info@prespartners.org.Orgainzational Level $1500.00 $1000.00 $500.00 $250.00 Payment Method My check will be mailed. (Please make payable to: National Preservation Partners Network) Please send me an invoice to pay online with a credit card or ACH payment. I would like to enroll in the program to automatically receive an annual membership invoice. Subscriber Email AddressesIf Organizational, Introductory, or Hardship Membership, please list names and email address of those in the organization (staff and/or board members) who should be added to the email newsletter distribution list and to the listserv.Affinity GroupsAll members are eligible to participate in one or more Affinity Groups. These are peer-led, informal calls to provide an opportunity for people with common interests/circumstances to connect, share best practices, and collaborate. If you would like to receive the Zoom link and calendar invite to these regular video calls (typically monthly-quarterly), please check the box(es) below. You can opt in or out at any time by emailing the director at info@prespartners.org. Big Cities Consultants Development Staff/Fundraising Easement-Holding Organizations Executive Directors Historic Sites/Museums Local Organizations New Executive Directors Organizations with One Staff or All Volunteer Organizations with 2-5 Staff Programs/Education Staff Organizations with 6-14 Staff Organizations with 15+ Staff Revolving Funds Rural Preservation Statewide Organizations Affinity Group Email AddressesIf the selected Affinity Group above is for a staff person other than the person completing this form, please provide the name and email address that should be affiliated with each Affinity Group.Board and Committee InterestAre you interested in learning more about becoming a board member or serving on a committee? Committees are open to all members. Board Advocacy & Education Committee Communications Committee Finance Committee Governance Committee Membership & Development Committee Consent(Required) I agree to the NPPN Code of Conduct.The National Preservation Partners Network adopted a Code of Ethical Conducts and expects all members, staff, and board to uphold it. In brief, the code of conduct state that NPPN will comply with all applicable laws and regulations and expects its directors, members, and employees to conduct business in accordance with the letter and spirit of all relevant laws; to refrain from any illegal, dishonest, harassing, demeaning, bullying and/or unethical conduct; to act in a professional, businesslike manner; and to treat others with respect.Please verify you are human:Consent I agree to the privacy policy.PhoneThis field is for validation purposes and should be left unchanged.