"*" indicates required fields HiddenMember Status HiddenPay by check override It looks like you’re already logged into an active member account. If you would like to apply for a different organization, please log out of this account and then submit a new application. Looking to update your existing organization’s information? Check out your member dashboard here.Geographic LocationIs your organization located in one of the geographic locations below?* No The Cameron Foundation: Tri-City Area of Petersburg, Colonial Heights, and Hopewell; the Counties of Dinwiddie, Prince George and Sussex; the portion of Chesterfield County lying south of Route 10. The Community Foundation of the Central Blue Ridge: Cities of Staunton and Waynesboro; Counties of Augusta, Nelson, and Highland. Obici Healthcare Foundation: Suffolk and Franklin; Surry, Dendron and Elberon in the eastern half of Surry County; Waverly and Wakefield in Sussex County; Boykins, Newsoms Courtland, Sedley and Ivor in Southampton County; Isle of Wight County; and Gates County, NC. PATH Foundation: Culpeper, Fauquier, and Rappahannock Counties. Please contact CNE to become a member through this Regional Partnership.Organization DetailHiddenRegion1 – Central Virginia2 – Tidewater and Eastern Shore3 – Northern Neck and Middle Peninsula4 – Northern Virginia5 – Charlottesville, Blue Ridge, and Valley6 – Western Virginia7 – Southwest8 – SouthsideStatewideNationalInternationalOrganization Name* Organization Website Organization Email*This will also serve as the username for your organization. You can add additional contacts in the next section. Organization Phone Number*HiddenOrganization Email Password*Set a password and use your Organization Email to log into your CNE dashboard anytime after you become a member (you will be automatically logged into your account after submitting this form) Enter Password Confirm Password Mailing Address* Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Focus Area*– Select –Animal Service/Animal Welfare/Wildlife ConservationArts and HumanitiesChildren/Youth (non-education)Civic/Community DevelopmentEducationEnvironmentFaith BasedFoundationsHealth and Safety/HealthcareHunger/Housing/PovertyInternational AffairsOtherSeniors/AgingSocial ServicesSpecial Needs/DisabledViolence Prevention/Legal JusticePrimary Focus Area Other* Service Areas*Select all that apply. 1 – Central Virginia 2 – Tidewater and Eastern Shore 3 – Northern Neck and Middle Peninsula 4 – Northern Virginia 5 – Charlottesville, Blue Ridge, and Valley 6 – Western Virginia 7 – Southwest 8 – Southside Statewide National International Submitting this first page of your application will create a user for your organization. If you do not complete your application today, you can come back to submit it at any time by logging into this user with the email provided above. CommentsThis field is for validation purposes and should be left unchanged.