MEMBERSHIP Print

Mission

The Multiple Sclerosis Coalition is an affiliation of independent MS organizations dedicated to the enhancement of the quality of life for all those affected by multiple sclerosis. The Coalition's mission is to increase opportunities for cooperation and provide greater opportunity to leverage the effective use of resources for the benefit of the MS community.

MEMBERSHIP APPLICATION FOR MS COALITION



Name of organization:*
Title:
Contact person:*
Mailing Address:*
Physical Address(if different than above):*
Phone Number:*
Fax Number:
Website:
E-mail:
Is your organization a 501 (c)3 organization?
Yes
No
What is your TID number?
How many full-time paid employees in the organization?
How many volunteers in your organization?
What is your mission statement?*
Geographic area(s) served:
Please list your primary programs and services over the last 12 months and the number of people served.*
Do you have a Board of Directors?
Yes
No
How many members comprise your organization?
Describe any other affiliations.
Attach latest 990 forms, names, occupations, The Board of Directors, and sample key publications

* Required field

We would appreciate any literature from your organization for our records.

If you for some reason can not submit online form please download, fill and mail your application to: MS Coalition
359 Main Street, Suite A
Hackensack, NJ 07661