Welcome to The Hispanic Coalition of North Texas, Inc Membership Application

HCNTX is not exclusive to Hispanic/Latino businesses or organizations.

First Name *

Last Name *

Phone *

Email *

I consent to receive non-marketing text messages from The Hispanic Coalition of North Texas, Inc about appointment confirmations and reminders. Message frequency may vary. Message & data rates may apply. Text HELP for assistance. Reply STOP to opt out.

I consent to receive marketing text messages about special announcements, program promotions, community initiatives, and event invitations from The Hispanic Coalition of North Texas, Inc at the phone number provided. Message frequency may vary. Message & data rates may apply. Text HELP for assistance. Reply STOP to opt out.

Address

Street Address

City

State

Postal Code

Business / Organization Information

Registered As *

How is your organization registered?

Business / Organization Name *

The name of your business or organization

Business Phone *

Business Email *

Website

Street Address *

City *

State *

Postal Code *

# of Members / Employees

Approximate number

Industry / Sector

e.g. Healthcare, Real Estate, Nonprofit, Education

Description

What does you business / organization specialize in or do?

Refer a Business

Know someone who would benefit from HCNTX? Share their info below. This step is completely optional.

Contact Name

First and last name

Organization Name

Business or organization name

Phone Number

Best number to reach them

MEMBERSHIP LEVELS

Select the membership tier that best fits your needs. Fees are billed annually.

Membership Level *

Business Logo

PNG, PDF, JPEG or JPG

Photo & Media Release *

I consent to photo release

By submitting this application, I grant permission to The Hispanic Coalition of North Texas, Inc to photograph, video record, and/or capture my likeness, voice, and participation during events, meetings, and activities. Images and recordings may be used for promotional, marketing, educational, and public relations purposes. No compensation will be provided. The Hispanic Coalition of North Texas, Inc retains full rights to use, edit, and distribute such content. I have read and agree to the Photo & Media Release terms above.

Acknowledgement

By signing below, I acknowledge that I have read and am in alignment with the organization's Vision and Mission Statements and have provided the above information to the best of my ability. Upon submitting this application, you will receive a Zeffy link to complete your membership payment. Questions? Contact us at [email protected] or (214) 790-4492.

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Date Signed *

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