NWA GLBT Community Center

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Linking Together to Build a Better Future

PO Box 1161,  Bentonville, AR 72712-1161 Phone: 1-888-391-9222

The Northwest Arkansas Gay, Lesbian, Bisexual and Transgender Community Center, Inc is a 501(c)3, tax exempt organization.

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New Member Application

To Apply by Postal Mail Please Print an Acrobat PDF Version of the Membership Application Form.

Please provide the following contact information: (* = Required)

    * First Name 
     * Last Name 
           Title 
    Organization 
* Mail Address   
 Address (cont.) 
          * City 
* State/Province 
 Zip/Postal Code 
         Country 
   Primary Phone 
 Secondary Phone 
             FAX 
        * E-mail 
             URL

Privacy Statement:

Your Privacy is important to us, therefore, we will not sell, rent, or otherwise give your email address to anyone.  Your email address will only be used in connection with this website.

        You may contact me with NWA GLBT Community Center related information only

     * Enter today's date: -- mm/dd/yy

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Code of Conduct:

The following activities are not allowed on Center property, Website, Online Groups or at any Center function:

  1. Physically or verbally threatening or harassing any person in any way.

  2. Using verbally explicit language, obscene gestures or racial, religious or ethnic slurs that are likely to upset or disturb the peace of clients, staff, volunteers or visitors.

  3. Engaging in sexual behavior.

  4. Defacing, damaging, or destroying property.

  5. Possession, use, or sale of illegal drugs, weapons or contraband.

  6. Possession or consumption of alcohol in any public area without prior authorization.

  7. Soliciting, for any purpose, including asking for money, contributions, or donations unless such activity has been approved by The Center.

  8. Assembling for the purpose of disturbing the public peace.

  9. Committing any unlawful act.

  10. Fighting, disrupting other activities, or in any way creating a disturbance which is disruptive or dangerous to others or the activities of The Center.

  11. Throwing, discarding or depositing any paper, glass, or other matter of any kind except in designated trash receptacles.

  12. Posting or distributing flyers or notices without prior approval of the center.

  13. Use of camera equipment unless such activity has been approved by The Center.

  14. Smoking inside of a building.

  15. Sleeping.

  16. Leaving unattended personal belongings or possessions without prior authorization of The Center.

  17. Using The Center facilities, Website, Online Group or Name for other than intended purposes.

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OUR MISSION:
The Northwest Arkansas (NWA) Gay, Lesbian, Bisexual and Transgendered (GLBT) Community Center will celebrate, strengthen and support the GLBT community of Northwest Arkansas across lines of age, ethnicity, faith, ability, gender and economics.
The mission will be achieved through advocacy, support and education of the GLBT community in Northwest Arkansas. The NWA GLBT Community Center will provide a safe and inclusive atmosphere for information, education, support, advocacy and resources for GLBT individuals and their allies. The NWA GLBT Community Center will be an umbrella to link, for a better future, new and existing organizations, cultures, and programs to meet the emerging needs of the GLBT community in Northwest Arkansas.

Legal acknowledgement:

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* I am applying for membership to The NWA GLBT Community Center and I agree with and support the Mission Statement, the Code of Conduct, and the Privacy Policy of The Northwest Arkansas Gay, Lesbian, Bisexual, and Transgendered Community Center. 

All statements on this application are true and correct to the best of my ability

Author: John Miller - Secretary.
Copyright © 2006 [NWA GLBT Community Center]. All rights reserved.
Revised: 02/28/07

Serving the Greater NW Arkansas Community's Needs

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All donations to the NWA GLBT Community Center are tax deductible to the fullest extent allowed by the Internal Revenue Service.
A copy of our Tax Exempt Status Letter is on file.  For a copy of the IRS document, please contact board@nwaglbtcc.org
Our Tax I.D. number is available upon request.  For a copy of a W-9 form, please contact board@nwaglbtcc.org

NWA GLBT Community Center © 2006-2008 All Rights Reserved