Community Shares of Utah

Agency Membership Application
  1. Please complete the following information completely so that we can review your Agency Membership Application. Starred items* are required.
  2. Membership Level(*)


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  3. Agency Name(*)
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  4. First Name(*)
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  5. Last Name(*)
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  6. Title(*)
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  7. Address(*)
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  8. City(*)
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  9. State(*)
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  10. Zip Code(*)
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  11. Phone(*)
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  12. Fax
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  13. Email Address(*)
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  14. Website
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  15. Federal EIN(*)
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  16. Incorporation Date(*)
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  17. Incorporation State(*)
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  18. Mission Statement(*)
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  19. What will your agency do to promote the growth of Community Shares?(*)
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  20. By submitting this application, my agency is applying for membership in Community Shares Utah. If accepted, we agree to be bound by Community Shares Membership Agreement, Bylaws, Policies, and Procedures.

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Community Shares/Utah participates in the Combined Federal Campaign, CFC Code #60848.

Upcoming Events

2012 Annual Golf Tournament
Fri Aug 17 @08:00AM - 05:00PM

Our Members