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Membership Application Form
To apply please send us the completed application form, along with your membership fee and all documents that apply to your group (see form). Your request will be reviewed by NBEN’s Steering Committee and the final approval will take place by our members during our Annual General Assembly.
Organization Name:
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Acronym:
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Address:
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City:
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Province:
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Postal Code:
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Telephone:
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Email:
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Website:
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Membership Fee to join your group:
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Number of Members:
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Membership criteria or restrictions:
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Year Founded:
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Number of staff:
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Newsletter or Publication:
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Frequency of Publication:
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What language(s) do you operate in?
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What language(s) do you operate in?
English
French
Mi’Kmaq
Wolustukwiyik (Maliseet)
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Preferred language of communication
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Preferred language of communication
French
English
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Is your group incorporated?
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Yes
No
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Does your group have a registered charitable status?
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Yes
No
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Applying as a:
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Applying as a:
Member
Associate
Mi'kmaq, Wəlastəkwey, Peskotomuhkati, or other indigenous organization
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Group's Main Contacts
Primary Contact Name:
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Position:
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Work Phone:
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Home Phone:
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Email:
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Secondary Contact Name:
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Position:
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Work Phone:
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Home Phone:
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Email:
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Additional member contacts (Please include names, telephones and emails):
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Information about the Group
What is the purpose or aims of your group (to promote…, to protect…in 50 words or less):
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Describe the nature of your organization (non-profit, volunteer-based, governance structure, affiliation or branch relationships - in 50 words or less):
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Are your activities:
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Are your activities:
Local
Provincial
Interprovincial
National
International
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What are your group’s main environmental services or activities:
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We provide the following services related to the environment (please select all that apply):
We provide the following services related to the environment (please select all that apply):
Children’s programs
Community planning
Ecological restoration
Environmental monitoring
Environmental research
Nature preserves or nature trails
Demonstration site
Original print, audio or visual educational resources
Resource library
Sale of Environmentally friendly products
Speakers
Workshops and events
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Please select one (1) type for your group:
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Please select one (1) type for your group:
First Nations or Aboriginal
International Development
Environmental Non-Government (ENGO)
Government-organized, non-government organization (GONGO)
Industry Association
Other Non-Governmental Organization or PIRG
Professional Association
Canadian Coalition or Network of NGOs
Formal Education Institution
Environmental Youth Group
Government
Labour Organization
Nature Centre
Research Institution
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Please indicate your group's top priorities:
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Please indicate your group's top priorities:
Agricultural
--> Food Issues
--> Intensive Livestock Operations
Assessment and Law
Atmosphere
-->Acid Deposit
-->Air Quality
-->Climate Change
Biodiversity and Wildlife
-->Animal Rights
-->Wilderness and Parks
-->Wildlife Protection (Endangered Species & Hunting)
Biotechnology
Ecology and Society
-->Environmental Technologies
-->Ethics/Spirituality/Philosophy
-->Labour & Environment
-->Lifestyle
-->Peace & Environment
-->Youth & Environment
Economy
-->Ecotourism
-->Sustainability
Education & Health
-->Sustainability Education
-->Outdoor Education
-->Outdoor Recreation
-->Environmental Health
Energy
-->Conservation
-->Renewable Energy (including wind, solar, tidal)
-->Conventional Energy (including hydroelectric, gas, coal)
-->Non-conventional fossil fuel (including shale gas, tar sands)
-->Nuclear Energy
First Nations
-->Indigenous Rights
-->Indigenous Knowledge
Forests
-->Forest Practices
-->Forest Restoration
Freshwater
-->Water Quality
-->Watershed Management/Water Use
-->Watershed Restoration
-->Wetlands
International Affairs
-->International Trade
-->International Development
-->Human Rights
-->Globalization
Land Use
-->Sustainable Communities/Community Development
-->Land Use Planning
-->Land Use Conflict
Marine
-->Marine Protected Areas
-->Coastal Marine
-->Fisheries
-->Aquaculture
Mining
Toxics
-->Hazardous Waste
-->Pesticides
-->Pulp & Paper
Transportation
Waste
-->Reduction, Recycling,Composting
-->Landfills
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Letter of support from a current NBEN member group
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A document that indicates your group’s purpose and governance structure (minutes, resolutions, organizational statement, constitution, annual report, etc passed by your group’s members):
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We have read and agree with the NBEN mission and by-laws.
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Fee due to the NBEN: Please select the appropriate amount
Fee due to the NBEN: Please select the appropriate amount
$40 For groups with budgets less than $1000
$50 For groups with budgets $1000 - $50,000
$75 For groups with budgets up to $50,000 - $125,000
$100 For groups with a budget greater than $125,000
For Mi'kmaq, Wəlastəkwey, Peskotomuhkati, or other indigenous organizations, the membership fee is waived.
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The membership fee will follow by mail.
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Form completed by :
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Please type in the letters and numbers provided before pressing submit:
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Refresh
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Submit Application
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