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New Member Form
Organization Information
Organization Name
*
Business Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Mailing Address
*
Is the address above where you would like to receive mail?
Yes
No, I'd like to provide a different mailing address
Mailing Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Administrative Phone Number
*
Website
Please include the full url: example: https://www.organization.org
Facebook
Please include the full url: example: https://www.facebook.com/ArtsLongIsland
Instagram
Please include the full url: example: https://www.instagram.com/ArtsLongIsland
Twitter
Please include the full url: example: https://www.twitter.com/ArtsLongIsland
Logo
Requirements: Format - JPG or PNG | File Size - 1MB or less
Primary Contact Information
Please list the person in your organization who should be the primary contact regarding Membership information.
Name
*
First Name
Last Name
Title
Primary Contact Email
*
Verify Email
*
Directory Email Address
*
This email address will appear in our Member Directory (we recommend using an address used for general inquiries.
Verify Email
*
BIPOC Focus
*
Are you an organization in which at least 50% of the board of directors identifies as Black, Indigenous, and/or People of Color (BIPOC), whose executive director or 50% of senior leadership (decision-makers) identify as BIPOC, and whose mission statement and/or programs aim to predominately serve BIPOC communities.
Yes
No
BIPOC Orgs
Please describe how the organization aims to predominately serve BIPOC communities:
Membership Dues and Payment
Your LIAA membership payment is based on your organization's annual operating expenses and tax status.
Membership Dues
Annual membership dues are based on your organization's reported annual operating budget, see chart below:
Annual Operating Expenses
Membership Dues
Under $250,000
$75.00
$250,000 - $499,999
$150.00
$500,000 - $999,999
$250.00
$1 - $4.9 Million
$375.00
$5 Million and above
$475.00
Commercial (for-profit) Entities
$500.00
Educational Institutions
$2,500.00
Membership Payment
$75
-
Annual Operating Expenses Under $250K
$150
-
Annual Operating Expenses $250K - $499K
$250
-
Annual Operating Expenses $500K - $999K
$375
-
Annual Operating Expenses $1M - $4.9M
$475
-
Annual Operating Expenses $5M +
$500
-
Commercial Entities
$2,500
-
Educational Institutions