Portland Parks & Recreation Friend TA Fund

Application2011-12

Pleasereview the Portland Parks & Recreation TA Fund Guidelines for information on eligible activities. TA Funds may be applied towardNAO membership for one year, 2011-12 Portland and Salem based NAO training network sessions and season passes, workshops and/or webinars. You are required to make a co-pay based on your organization’sannual budget.

Please mail this form to 5100 SW Macadam Avenue, Suite 360, Portland, Oregon 97239,

Attn: Micaela Kennedy, or emailto,orfax to 503.236.8313.

Please allow one to two weeks for processing your request. You will receive notification by email.

Organization Name

Mailing Address

CityState Zip

Contact Person Position

Phone Number E-mail

NAO Membership

Nonprofit membership dues are based on your organization’s budget:

  • Up to $50,000: $35 annual dues
  • $50,001 to $100,000: $75 annual dues
  • $100,001 to $250,000: $125 annual dues
  • $250,001 to $500,000: $175 annual dues
  • $500,001 to $999,999: $225 annual dues
  • $1,000,000 to $5,000,000: $275 annual dues
  • Over $5,000,000: $400 annual dues

Subtotal Nonprofit Membership Fee $

Affiliate members include other tax exempt organizations and government agencies, consultants that serve nonprofits, business partners, and individuals who support nonprofits. Most are eligible for member benefits, including discounts on NAO workshops and events, but are not eligible to vote. There are two memberships based on business size:

  • Small (1-49 employees) $125 annual dues
  • Large (50+ employees) $250 annual duesSubtotal Affiliate Membership Fee $

Publications

The Oregon Nonprofit Corporation Handbook, a comprehensive guide to setting up and operating a nonprofit organization in Oregon /  $75
pdf download available for $60
 $9 Shipping
Chapter 13 of the Handbook is a practical guide for nonprofit Boards of Directors, and is available separately /  $10
 $5 Shipping
Oregon Foundation Databook–10th Edition, a listing of grantmaking foundations / $120
 $9 Shipping
$160 Book w/ CD
 $9 Shipping

Subtotal Publications $

Total TA Fund Activities (membership, pubs) $

Network Series –2011-12Season Pass

Scholarships may be applied towarda season passfor up to two representatives from your agency (see Guidelines for topics and dates or visit ). Eligible networks are those scheduled in Portland and Salem.

Name/TitleEmail

Name/TitleEmail

Subtotal for Network Season Passes $______

Individual Training Network

Guidelines for topics and dates or visit . Eligible networks are those scheduled in Portland and Salem.

Name/TitleEmail

Name/TitleEmail

Subtotal for individual Networks $______

NAO Workshops(full or half day events only) & Webinars

Scholarships may be applied toward the price of the training workshop and/or webinar.Visit for more information and to view the 2010-2011 training calendar. You can send up to two agency representatives to the workshop of your choice.

Workshop TitleDateCost/participant

Attendee #1Name/TitleEmail

Attendee#2Name/TitleEmail

Subtotal Workshop Fees$

Total TA Fund Activities (training, workshops, membership, publications) $

Co-Pay

Each grantee of thePortland Parks & Recreation TA Fund is required to make a co-payment toward the total cost of the technical assistance activities they are requesting from the Nonprofit Association of Oregon, based on organization budget:

Organization Budget / Co-Pay
Less than $100,000 / 10%
$100,000–$250,000 / 25%
$250,000–$500,000 / 50%
Over $500,000 / 75%

Your Co-pay $

Total Portland Parks & Recreation TA Fund Request(TA Fund Activities less co-pay) $

Co-Payment Method: Check is enclosed Visa MasterCard

Total amount (your co-pay):$

Card number: Exp. Date:

SignaturePrint name as it appears on the card

Billing addressCity/state/zip

THE NONPROFIT ASSOCIATION OF OREGON / / P 503-239-4001 / F 503-236-8313