New Brunswick Environmental Network

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?(*)

English

French

Mi’Kmaq

Wolustukwiyik (Maliseet)

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Preferred language of communication(*)

French

English

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Is your group incorporated?(*)

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Does your group have a registered charitable status?(*)

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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:(*)

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):

Please select one (1) type for your group:(*)

Please indicate your group's top priorities:(*)

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

$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:(*)

Refresh

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Membership Application Form

Group's Main Contacts

Information about the Group