$30 - budget up to $50,000
$50 - budget $50,000 - $100,000
$75 - budget $100,000 - $500,000
$125 - budget $500,000 - $1,000,000
$200 - budget $1,000,000 - $2,000,000
$300 - budget over $2,000,000

* Email

* Password

* Confirm password

Note: An email address and password are required if you wish to access the members-only sections of this website.

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First name

Last name

Title

* Organization name

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* Address

Address, line 2

Suite/room #/apartment

* City

* State / zip
Please choose Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  / 

Geographic location
Please choose City of Boston Greater Boston (within Route 128/95) Within Route 495 Within Massachusetts Within New England Within USA Outside USA

Work phone

Fax

Web address

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Professional affiliation of primary subscriber
Please choose Professional affiliation Youth worker Manager in girl-serving nonprofit Researcher School teacher Counselor/therapist College/graduate student Girl Parent Funder Media Community volunteer Other Policymaker/legislator/women's commissioner Manager in women's organization For-profit professional

Type of organization
Please choose Girls' only program/organization Coed program/organization Girls' only service/health agency Coed service/health agency Girls-only school Coed school Research or academic institution Girls' only advocacy program Coed advocacy program Girl-focused coalition Funder Media Library Professional organization Recreational club Parent organization Women's organization Government organization Corporation/for-profit Other

How did you hear about us?
Please choose Girls' Coalition event, publication or flyer Other conference/event Word of mouth Girls' Coalition contacted me Web search Link from another web site Other Through media source

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What member benefits are you interested in?

Receiving invitations to Girls' Coalition events/trainings
   Hardcopy    Email    Both    None

Receiving our publication "Girl Matters," exploring topical issues from multiple perspectives
   Hardcopy    Web    Both    None

Receiving email updates about girl-focused programs, events, opportunities, trainings, and funding opportunities
   Yes    No

Receiving email updates about the latest research and resources on girls
   Yes    No

Receiving email updates about advocacy issues related to girls
   Yes    No

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Please add up to four (4) additional individuals for membership. These individuals will receive and email notification of their membership with their username and password once the membership is complete.

Member #2

First name / Last name
  

Position

Email

Member #3

First name / Last name
  

Position

Email

Member #4

First name / Last name
  

Position

Email

Member #5

First name / Last name
  

Position

Email

I give my permission to be listed in the Girls' Coalition member directory, including all of the above information:
   Yes    No

This option will take you to Acteva and allow you to pay online using your credit card through a secure method.

This option will have an invoice sent to you from the Girls' Coalition. You can then mail a check or money order in with a copy of your invoice. Please note that you will have 60 days of benefits and if we do not receive your check by that time, we will need to terminate your benefits.