Community Partner

By enrolling with IANT, your organization will abide by the IANT bylaws. We retain the right to refuse your partnership.

Organization Name *

Organization Website (with http://) *

Year Established *

Organization Phone *

Organization Email*

Current Board Term Eg: JAN to DEC 2025 *

Current President Name *

Current President Phone *

Current President Email *

Current Secretary Name *

Current Secretary Phone *

Current Secretary Email *

President Elect/VP Name *

President Elect/VP Phone *

President Elect/VP Email *

No of Attending Board Members(Including yourself) *

1

2

3

4

Organization Logo *

Organization 501c(3) Status Document *

Additional Board Member Names / Comments

Your Organization Vision *

Agree to receive IANT Newsletters and/or information? *

Yes

No

* Indicates required question

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