JOIN NEN This application form and the accompanying credit card payment form must be filled out and submitted online. If you wish to fill out a paper form, please print out this PDF version and mail with payment to NEN. NEN Parters are entitled to our Into Practice bulletin (appoximately 20 per year), three webinar registrations, three hours of individual consultation, and special consideration for inclusion in NEN's ever expanding best practice research and professional development projects. NEN Subscribers are entitled to subscription of Into Practice bulletin, our grantwriting newsletters, and related e-newsletters and announcements.   We are enrolling as: an NEN Partner    an NEN Subscriber   Organizational Information Your First Name: Your Last Name: Agency Name: Address: City: State: Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip:    Phone: Fax: Email: Program Name: [if applicant is different from umbrella organization] Address: City: State: Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip:    Phone: Fax: Email: My organization has multiple sites Main Contact Person First Name: Last Name: Address: City: State: Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip:    Phone: Email: Other Contacts List the names and email addresses of all people in your organization who should receive regular NEN online bulletins such as Into Practice and Grantwriters' Resource. First Name Last Name Email                                                 Fees Choose One: Partner   $550 Annual Flat Fee Subscriber    $150 Annual Flat Fee Please make accompanying payment online via credit card.