MEMBERSHIP APPLICATION
Women’s International Network (WIN) - P.O. Box 941192 - Plano, TX 75094-1192
Email application to: womensintlnetwork@htomail.com
POTENTIAL MEMBER INFORMATION:
Name of Organization: ________________________________________________
Your Name: _________________________________________________________
Your Title: __________________________________________________________
Address: ___________________________________________________________
City/State/Zip:_______________________________________________________
Phone: ______________________ Alternate Phone: ______________________
Fax:_________________________ Work Phone: _________________________
Email Address: _____________________________________________________
Website Address: ___________________________________________________
Type of Organization: ______ Profit ______ Non-Profit
Describe your organization and products/services you provide.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Years in Organization: ______________ Are you incorporated? Y/N
State Inc.: _____________
REFERENCES: (Please provide at least two references)
Name: ____________________________________________________________
Title/Organization: __________________________________________________
Telephone No: ___________________________
Name: ____________________________________________________________
Title/Organization: __________________________________________________
Telephone No: ___________________________
PLEASE READ THE FOLLOWING:
I, ______________________________________, understand that my references listed on this application may be verified by the Women’s International Network (aka WIN) organization to ensure my character is of sound and excellent reputation. I understand that WIN does not provide any type of accountability or covering and can in no way attest to the soundness of my organization. I understand that WIN is an organization established solely for the purpose of networking resources with other WIN members in a concentrated platform.
I understand that my contact and association with any of the WIN members is strictly voluntary. The WIN organization is not responsible for any non-contractual, verbal, or contractual agreements entered between WIN members. I perpetually release the WIN organization from damages, claims, or liabilities for such relationships. It is highly recommended by WIN board members and president/founder to contact legal representative before entering into any type of agreements with WIN members.
WIN is not responsible for claims about products and services of any WIN members verbal or non-verbal including written pamphlets, websites, brochures, and any other materials stating claims about WIN members products and services. I perpetually release the WIN organization from damages, claims or liabilities resulting from claims concerning WIN members products and services.
I will provide financial support to defray the WIN budget as often as I can. With this application, I have included $______ and understand that financial support is not mandatory.
Signature of Applicant: ___________________________ Date: __________________
Print Name: ________________________________________________________
Do not email application form. Please mail completed and signed form to: Oasis International Church (formerly Living Water Bible Church), WIN, P.O. Box 941192, Plano, Texas 75094-1192. You will be notified within two weeks of submittal if your application has been accepted.
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BELOW FOR OFFICE USE ONLY:
Staff Reviewer Name: ________________________________________________
Review Date: ________________
Application Accepted: _______ Application Denied: _______
References Verified: Y/N By Whom:_____________________________________
Further Review Recommended: Y/N
Comments: ________________________________________________________
__________________________________________________________________
__________________________________________________________________
Amount Offering: $ ________________ Method: ________________
