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Letter of Affiliation 2016
My organization/agency,
is a member of the North Shore Community Health Network (“The Network”).
As such, we support the mission of the Network and its strategic emphasis, and agree to
participate in its activities. Participation may include one or more of the following: attending
meetings annually; participating in work groups, conference calls, surveys or other memberrelated activities; providing in-kind services or expertise; grant review and resource allocation;
event planning and activity promotion.
Network membership provides access to: funding opportunities; training and professional
development for staff; networking with other area health and social service organizations;
information through electronic newsletters and other means; and community recognition.
Membership assumes permission to print the name of your organization on Network
promotional materials, and grants you the opportunity include the Network in your
organization’s materials.
Membership is renewed every three years or upon submission of an application for funding.
Name: _________________________
Title: ___________________________
E-mail: _________________________
Telephone: ______________________
Signature: ______________________
Date: ___________________________