TO BE CONSIDERED A NEW ORGANIZATION:

You need to have a facility to be able to effectively serve 100 youth members, a sustainable budget or existing program you can merge or enhance, and support from your Tribe. Your youth serving program must honor the mission of Boys & Girls Clubs of America to enable all young people, especially those who need us most, to reach their full potential as productive, caring and responsible citizens. If the Club meets all of the above criteria please complete a New Organization Application.

Section A: Corporate Information

  1. Enter the name of the Organization
  2. Enter the location address of the Organization
    2a. Enter the County name where the Organization is located
  3. Enter the mailing address of the Organization
  4. Enter the shipping address of the Organization
  5. Enter the phone number of the Organization
  6. Enter the fax number of the Organization
  7. Enter the Website Address of the Organization (if applicable)
  8. Enter Yes or No in response to the question. If yes, then enter the date of incorporation and attach the Articles of Incorporation, constitution, and bylaws.
  9. Enter Yes or No in response to the question
  10. If the answer to #9 is no, enter the answer to this question.
  11. Enter the name of the governing body (ex. Board of Directors)
  12. Enter who selects or elects the members of the governing body
  13. Enter Yes or No in response to the question
  14.  Enter how often the governing body meets (ex: monthly). (Please attach a list of the Board of Directors or governing body with their business affiliations and contact information)
  15. Enter Yes or No in response to the question (Be sure to attach a current copy of the Certificate of Insurance naming BGCA as an additional insured)
  16. Enter Yes or No in response to the question (Be sure to attach the 501©(3) Letter of Determination)

Section A1: Other Membership Requirements

This group is a series of Yes or No questions.

Section B: Chief Professional Officer Information

  1. Enter the name of Chief Professional Officer and the date started in the position
  2. Is the CPO from Inside or Outside of the Boys & Girls Club Movement? What date did they join the Movement?
  3. Enter their street address (office)
  4. Enter city, state, and zip code information
  5. Enter the phone number information (office, cell, fax)
  6. Enter their email address
  7. Enter the CPOs date of birth and ethnicity

Attach a copy of the CPO’s Resume.

Section B1: Boys & Girls Club Staff

In the box provided, please enter the following information in regards to other staff members working in the in the Organization’s Administrative Office:

  • Name
  • Title
  • Annual Salary
  • Status (Full Time or Part Time)

Section C: Chief Volunteer Officer Information

  1. Enter the name of Chief Volunteer Officer and the date started in the position
  2. Is the CVO from Inside or Outside of the Boys & Girls Club Movement? What date did they join the Movement?
  3. Enter their street address (office)
  4. Enter city, state, and zip code information
  5. Enter the phone number information (office, cell, fax)
  6. Enter their email address
  7. Enter the CVOs date of birth and ethnicity

Section D: Minimum and Essential Benefits

This group is a series of Yes or No questions. The Club is required to pay at least 50% of the Minimum and Essential Benefits.

Section E: Financials

Please read and answer all questions carefully.

Attach a copy of itemized budget for first operating year.

Section F: Contact Person for Application Questions

Enter Name, Job Title, Phone and Email Address.

Required Signatures

  • Chief Volunteer Officer or Board President of the Boys & Girls Club Organization requesting membership
  • Director of Organizational Development, BGCA
  • National Vice President, Regional Vice President, or National Director, Organizational & Executive Development, BGCA
  • Senior Vice President, Organizational & Executive Development, BGCA

Required Supporting Documentation

  • Articles of Incorporation
  • Standards of Operational Effectiveness (SOE) Rating
  • 501 © (3) Letter of Determination from the IRS
  • Board of Directors listing complete with business affiliations and mailing addresses
  • Constitution, By-Laws and Rules
  • Current Certificate of Insurance with BGCA named as an additional insured with the National Headquarters address
  • Copy of Chief Professional Officer’s Resume
  • Copy of the Organizational Budget
  • Completed Unit or Extension Application with all necessary attachments

Disclaimer: Upon completion of the application and all attachments, obtain the signature of the Chief Volunteer Officer or Board President, and speak with your Director of Organizational Development to determine the proper way for the application to be submitted.