SEIA Affiliate Application Form
Thank you for your interest in becoming an official SEIA affiliate! In order to begin the process, please fill out the form below. If you have any questions regarding the application process, contact Colin Silver at
csilver@seia.org
.
First Name
Last Name
Email Address
Phone Number
Organization Name
Website URL
Please attach a copy of the organization’s articles of incorporation
Please attach a copy of the organization’s bylaws
Please attach a copy of the organization’s Certificate of Good Standing from the state of incorporation
Please attach a copy of the organization’s IRS determination letter showing the 501c6 tax status of the organization. If your organization is not currently a 501c6, please submit your IRS determination letter and we will discuss this at the next step in the affiliation process.
Please attach a copy of the organization’s contact information for officers
Please attach a copy of the organization’s list of paid employees
Please attach a copy of the organization’s list of board members of the chapter, including board positions
Please attach a copy of your dues structure
Do you have a Political Action Committee (PAC)?
Yes
No
Please provide a list of your accomplishments, if applicable. If your organization does not have a list of recent accomplishments, please explain why (for example, your organization may have just formed).
Please attach any additional documents that you would like us to review (This may include regulatory submissions, press releases, etc.).
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.