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Section 1 of 1
Form title
Application for Organization Membership to the US Food Sovereignty Alliance
Form description
Please read the new Structure Document in full before submitting a membership application. Submission of the membership application signifies that your organization is in alignment with the vision, the principles, and the goals laid out on the website and is also committed to fulfilling membership responsibilities.
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Name of Organization
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Name of Organization
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Organization Address
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Organization Address
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Phone
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Email
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Website
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Facebook Page
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Facebook Page
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Twitter
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Twitter
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Contact or Representative
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Contact or Representative
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Also include their individual contact information (phone and email) if it is different than the phone and email listed above.
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Additional Contact or Representative
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Additional Contact or Representative
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Also include their individual contact information (phone and email) if it is different than the phone and email listed above.
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Membership Category - "Grassroots" or "Grassroots Support"
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Membership Category - "Grassroots" or "Grassroots Support"
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GRASSROOTS ORGANIZATION: Main decision-making body, leadership, and membership are formed by specific social group (e.g. Farmworker, Farmers, African-Americans, Women, etc.)
GRASSROOTS SUPPORT ORGANIZATION: Not a membership-based organization; Main decision-making body, leadership, and staff are largely formed by different social sectors.
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Your Organization's Structure and Constituency
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Your Organization's Structure and Constituency
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Please indicate whether you are a network, a coalition, a community-based membership organization, an organization made up of professional staff, a Women's organization, a Farmworker organization, etc. Who is your constituency?
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Your Organization's Work
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Your Organization's Work
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Please list 3 issues that your group works on. Does your group have any existing campaigns? If so, please list them.
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Your Organization's Goals
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Your Organization's Goals
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Why is your group interested in joinin ghte US Food Sovereignty Alliance? What do you hope to achieve through participating in the Alliance?
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Your Organization's Networks and Allies
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Your Organization's Networks and Allies
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Who are your strategic partners, at any level, and especially related to food sovereignty?
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Regional Representation
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Regional Representation
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Which regional team would you participate in? Organizations with an otherwise national scope should participate in the region where their office(s) is/are based.
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Northeast
Southeast
Midwest
Southwest
West/Northwest
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Collectives
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Collectives
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Which area of work would you be interested to participate in?
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Agroecology, Land and Water
International Relations
Narrative Strategy
Political Education
Youith Process
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Would you be interested in being a Spokesperson for the USFSA?
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Would you be interested in being a Spokesperson for the USFSA?
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Yes
No
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Additional Comments
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Is there anything else you want to share?
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Name of Organization
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Organization Address
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Phone
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Email
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Website
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Facebook Page
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Twitter
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Contact or Representative
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Additional Contact or Representative
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Membership Category - "Grassroots" or "Grassroots Support"
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Your Organization's Structure and Constituency
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Your Organization's Work
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Your Organization's Goals
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Your Organization's Networks and Allies
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Regional Representation
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Collectives
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Would you be interested in being a Spokesperson for the USFSA?
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Additional Comments
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