Untitled Document
The Surplus Exchange
MEMBERSHIP APPLICATION
Organization ___________________________
Phone __________________ Fax __________________
Address _______________________________
City__________ State _____ Zip_________
Authorized Official _______________________________
Title ________________ Alt phone# _________________
Email _______________
Other Representative _____________________________
Alt phone# ___________________
Email _______________________
Other Representative _____________________________
Alt phone# ___________________
Email _______________________
Membership with The Surplus Exchange is designated for Non-profit
Organizations which are exempt from Federal Income Tax. Current proof
of Non-profit status must be on file at all times with The Surplus
Exchange.
Lifetime membership with The Surplus Exchange is Fifty Dollars per
organization, payable with this application. Although we will not
require additional fees to maintain your membership, we do ask for
occasional updated documentation of yoiur Nonprofit status.
In order to serve your organization best, we also ask that you send
us a brief summary, or Mission Statement, describing your organization.
I, the undersigned, have read and understand the abouve, and affirm
that my organization meets the membership criteria.
Signiture_____________________________Date______________