Section 1: Partner Contact Information

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Section 2: Partner Rights and Responsibilities

The Designated Organizational Representative to the National Campaign has read and understands the "2007 National Campaign Partner Agreement" document, available at PartnerAgreement2007.php. (If you would prefer a hard copy to review, please call us at 845 361-5201 and we will mail or fax it to you.)

Our organization is a:

Our organization is applying to be a (see partner agreement sections 4, 5 and 6 for details)

Our organization would would not like to be listed in the partner directory (Partner Agreement point 7b).

Our organization is is not interested in using the Sustainable Agriculture Movement Database Technology

Section 3: Policy

If you have policy staff, please indicate how many on local   state   national

In which of the following issue committee(s) will the Designated Organizational Representative participate?

Active committees as of January 2007 (choose at least one)

Do/will other members of your organization participate in National Campaign committees? If so, please list

Section 4: General Questions about Your Organization

How many staff members do you have?

Is your organization membership based? Yes No

If so, how many members do you have?

Are your members individuals or organizations? Individuals Organizations Both

What is your geographical focus? (choose) local state region national international

If it is local, state, or regional, please specify

What issue(s)/constituencies does your organization focus on?

Section 5: Organizing

If you have organizers on staff, please indicate the number: local   state   national

Do you have an action alert network? Email   Fax   Phone Tree   by Mail

If so, how many people do you reach?

Do you:
simply forward action alerts from National Campaign as they come to you,
or do you tailor them,
or does it depend on

What organizing skills/resources does your organization need/want?

Do you offer any training or materials? If so, what and when?

Are you willing to organize other people from our network? Yes   No

Section 6: Media/Communications

Do you have a newsletter? Yes   No

What is your organization's media capacity (i.e. do you have well developed contacts? Do you write op-ds/press releases? Do you sponsor farm tours? Do you have communications staff?)

Are you willing to include National Campaign information in your newsletter, listserve or other communications? Yes   No

Section 7: Annual Dues:

The National Campaign requests that each Partner Organization pay annual dues a) to demonstrate commitment to and financial support of the National Campaign's work, and b) in recognition of the valuable opportunities and services that the National Campaign provides to Partner Organizations.

The National Campaign has a sliding scale for Partnership Partner Organization Dues, based on the annual organizational budget: No organization will be denied partnership for economic reasons. The National Campaign expects partner organizations to participate in and support the activities of the National Campaign, above and beyond the payment of dues.

Partner Organizations that are able to make a larger contribution to the work of the National Campaign are strongly encouraged to do so.

We are sending a check for .
We request a 1 time reduction (please provide explanation)

We request a full waiver (please provide explanation)