United States Membership Application Training Center Volunteer Opportunities Contact World Vision U.S. Programs – Essential Supplies Center Membership Application Form Organizational Profile "*" indicates required fields 12345 Is this a new membership?* Yes No Organization Name* Federal Tax ID #* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Director* First Last Contact Email* Website Organization Type* Community Based Organization Church Public / Government Agency Faith Based Organization School Church Size* 0 - 500 500 - 1000 1000 - 1500 1500 - 2000 2000+ Programs (Choose all that apply) Advocacy Disability Services Early Childhood Development Economic Development Education / After School Food Pantry / Feeding Program Foster Care Health Services Unhoused Housing / Rent Job Training / Workforce Skill Development Immigrant-Refugee Services Prenatal / Maternity Care Recovery Services / Drug Rehabilitation Recreation Re-Entry Programs Spiritual / Religious Programs Special Need Children Senior Care Services Violence / Crime Prevention Youth Development Youth Mentoring Other Other Program What is your primary program focus?* How many individuals are served by your organization yearly? (Consider all your events, programs, outreach, etc.)Children ServedPlease enter a number from 0 to 999999.Adults ServedPlease enter a number from 0 to 999999.Total*Please estimate the percentage breakdown of your program beneficiaries by age:Beneficiaries Ages 0-5Please enter a number from 0 to 100.Beneficiaries Ages 6-12Please enter a number from 0 to 100.Beneficiaries Ages 13-18Please enter a number from 0 to 100.Beneficiaries Ages 19-65Please enter a number from 0 to 100.Beneficiaries Ages 66+Please enter a number from 0 to 100.Total*Please estimate the percentage breakdown of your program beneficiaries by ethnicity:Black / African American PercentagePlease enter a number from 0 to 100.Asian PercentagePlease enter a number from 0 to 100.White PercentagePlease enter a number from 0 to 100.Hispanic / Latino PercentagePlease enter a number from 0 to 100.American Indian / Alaskan Native PercentagePlease enter a number from 0 to 100.Native Hawaiian / Pacific Islander PercentagePlease enter a number from 0 to 100.Two or more races PercentagePlease enter a number from 0 to 100.Total*Please estimate the percentage breakdown of your program beneficiaries by gender:Female PercentagePlease enter a number from 0 to 100.Male PercentagePlease enter a number from 0 to 100.Total*Please estimate the percentage breakdown of your program beneficiaries by type:Immigrant / Migrant PercentagePlease enter a number from 0 to 100.Native American PercentagePlease enter a number from 0 to 100.Inner City PercentagePlease enter a number from 0 to 100.Rural PercentagePlease enter a number from 0 to 100.Other Beneficiaries Types PercentagePlease enter a number from 0 to 100.Total* Briefly state the mission of your organization:* World Vision’s educational programming provides academic support and enrichment for students and their families.*Would you be interested in World Vision’s educational programming? Yes No World Vision’s Disaster Response programming provides support through partnership with churches to serve the most vulnerable families affected by emergencies.*Would you be interested in partnering with World Vision’s through our Disaster Response programming? Yes No CAPTCHA
