2014 New Member Application for Individuals

Individual New Member Application

 
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Our Vision

By 2020, the Colorado Coalition Against Domestic Violence (CCADV) will be the trusted and valued state leader in expanding the capacity of Colorado's domestic violence programs, allied professionals, policymakers, and the public to dramatically reduce domestic violence in the state.

Through training, technical assistance, resources and support, CCADV helps build the capacity of domestic violence program members and allied professionals to meet the needs of the survivors and communities they serve. We increase safety and support for survivors by engaging in policy and systems change. We participate in and build coalitions to create change through our collective voice, and serve as Colorado’s resource center for reliable information on issues related to domestic violence.

Thank you for your interest in joining the Coalition! The 2014 annual dues for individuals are $100.

* Please note: If you need a copy of this form for your records, please print each page (using the print function in your web browser) before clicking next.
1. Name:
2. Contact Information:
3. Email Address: (This will be included in our CCADV MEMBER listserv)
4. Please briefly describe your reasons for wanting to join the Coalition and any ways you have been or are currently involved in work to end domestic violence. Please include your affiliation with any other domestic violence related organizations.
5. Please indicate if you are interested in getting more involved with CCADV (CCADV staff will contact you to explore options).
6. Do you have areas of expertise that you would be willing to share with CCADV?
7. Are you aware of the types of training and technical assistance that CCADV can provide to you?
8. I agree that entering my name below constitutes my electronic signature.