California Partnership to End Domestic Violence

Individual Submitting Application on Behalf of Organization

Name

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First Name

Last Name

Pronouns

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Title

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Email

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Verify Email

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Phone

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Organizational Information

Organization Name

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

County

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Phone

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Fax

Organizational Website

Please enter the email address where you would like to receive renewal invoices.

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Per the Partnership's bylaws, all member organizations must be headquartered in California.

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I affirm that this organization is headquartered in California.

Organizational Leadership

Executive Director's Name

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First Name

Last Name

Executive Director's Pronouns

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Executive Director's Email

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Executive Director's Phone

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Designated Voter

Every organization must have one designated voter. Please enter the name and email address for this individual.

Name

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First Name

Last Name

Title

Email

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To be compliant with State law regarding online elections, please have your designated voter complete this consent form.

I agree, acknowledge and consent to use of electronic transmissions in accordance with Sections 20, 21 and 5079 of the California Corporations Code and Section 6.10 of Partnership Bylaws.

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Yes, I agree.

I am not the designated voter. I will have our designated voter submit the above consent form.

Organization's Mission Statement

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Organizational Budget (your current fiscal year)

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Describe your DV prevention and/or intervention programs / services.

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Does your organization provide sexual assault programs or a rape crisis center?

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Yes

No

Is your organization, program or project dual domestic violence and sexual violence?

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Yes

No

Is your organization, program or project a Qualified Legal Services Provider?

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Yes

No

Is your organization a culturally specific organization?

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Yes

No

Is your organization tribal specific?

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Yes

No

Is your organization a government agency?

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Yes

No

Does your organization, program or project operate a crisis line?

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Yes

No

Please enter your crisis line / hotline number.

Does your organization, program or project provide shelter services?

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Yes

No

Please enter how many emergency shelter beds you have.

How did you hear about the Partnership?

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Why is your organization, program or project interested in joining the Partnership?

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MISSION & VALUES

Our Vision

A California free from domestic violence.

Our Mission

The California Partnership to End Domestic Violence promotes the collective voice of a diverse coalition of organizations and individuals, working to eliminate all forms of domestic violence. As an advocate for social change, we advance our mission by shaping public policy, increasing community awareness, and strengthening our members’ capacity to work toward our common goal of advancing the safety and healing of victims, survivors and their families.

Values / Guiding Principles

Partnership: We represent California's rich diversity.
Equity: We shift power so underrepresented voices frame our approach.
Beloved Community: We support and stand with communities grounded in justice and love.
Bravery: We embrace discomfort, taking informed and inspirational risks to disrupt the status quo.

I have read and agree to support the Partnership's Mission & Values.

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Yes

This application is on behalf of a:

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Community-based organization

Tribal entity (any tribally-affiliated group, including a tribal government)

Governmental agency (excluding tribal government entities)

Multi-disciplinary committee or coalition

Is your organization dedicated to domestic violence prevention and/or intervention?

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Yes

No

Do you have specific program(s) or project(s) within your organization that are dedicated to domestic violence prevention and/or intervention?

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Yes

No

Is this entity dedicated to addressing other intersecting social justice issues (related to, but not specifically domestic violence)?

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Yes

No

Does this entity prevent and/or intervene in domestic violence?

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Yes

No

Does this entity address other intersecting social justice issues (related to, but not specifically domestic violence)?

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Yes

No

Your organization seems to best fit as a Level 1: Primary Purpose Domestic Violence Organization.

Organizations in this category receive 10 votes each year, and an unlimited number of profiles.

Dues are based off of your organization's budget.