Join or Renew | Media Impact Funders

Organization (Please note: Membership is open to funders only.)*

Organizational Contact's First Name*

Organizational Contact's Last Name*

Organizational Contact's Title

Email*

Membership Type

New
Renewal

Membership Level*

Organizational
Individual

Address*

Street Address Address Line 2 City State ZIP Code

Phone

Your Organization's Areas of Interest

Does your organization consider payment of these membership dues to be a grant? (If so, please forward any required paperwork to membership@mediafunders.org.)

Yes
No

Please provide contact information for anyone else in your organization we should add to our mailing lists.

Membership Rate Structure
$250	Individuals based at foundations and qualifying organizations who are not in a position to provide Media Impact Funders membership.
$500	Foundations, private donors and organizations with an annual grants budget under $1,000,000
$1,000	Foundations, private donors and organizations with an annual grants budget between $1,000,000 and $4,999,999
$2,500	Foundations, private donors and organizations with an annual grants budget between $5,000,000 and $9,999,999
$5,000	Foundations, private donors and organizations with an annual grants budget between $10,000,000 and $19,999,999
$7,500	Foundations, private donors and organizations with an annual grants budget between $20,000,000 and $49,999,999
$10,000	Foundations, private donors and organizations with an annual grants budget of $50,000,000 or more
$10,000+	Media Impact Funders welcomes Supporting Memberships beyond $10,000 from funders who have it within their capacity.

Dues Amount (Membership dues are based on organization’s grantmaking budget.)*

For dues in excess of $10,000, kindly pay via check. If you prefer an alternative method of payment, please contact us at membership@mediafunders.org.

Payment Method*

Make checks payable to: Media Impact Funders

Mail to:
Media Impact Funders
200 West Washington Square
Suite 220
Philadelphia, PA 19106

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Become a member or renew your membership.