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To Register Your Disaster Interfaith
Please complete the membership application form to join NDIN.
A. Organization
• Organization:
• Type:
• Program Focus:
 
B. Contact Information
• Title:  
• First Name: • Last Name:
• Position Title:
   
• Phone 1: Ex:123.123.2345 • Phone 2:
• Cell Phone: • Fax:
• Email:
Web:
   
C. Location
• Office Address: floor/office:
• City:
• State: • Zip code:
 
• Mailing Address: floor/office:
• City:
• State: • Zip code:
 
D. Services/programs your organization provides:
 
Advocacy
Case Management
Chaplaincy/Spiritual Care
Child/youth Services
Disaster Relief 		Donations Management
Emergency Servives
General Social Services
Health Services
Mental Health Services
Preparedness
Recovery Coordination
Training/Certifications
Volunteer Management
Work Camps
Others:
   
   
4 West 43rd Street - Suite 407, New York, NY 10036
info@n-din.org - Phone: 212.669.6100 - Fax: 212-354-8251
Copyright © 2007 National Disaster Interfaiths Network (NDIN). All Rights Reserved.