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NPEP Registration Form
The MDEM Nonprofit Engagement Program was created to cultivate, strengthen, and effectuate synergistic whole community collaboration among nonprofit organizations in Maryland. The program aims to connect Maryland nonprofit and community organizations to emergency preparedness and capacity building resources that support mission prosperity and organizational resilience while focusing on relationship building, local engagement and whole community collaboration. If your organization is interested in full NPEP Registration, please complete the Registration form below to join the NPEP Community!
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* Indicates required question
Email
*
Your email
Organization Name
*
Your answer
Organization Type
*
Nonprofit Organization
Community Organization
Religious or Faith based Organization
Other:
Organization Employer Identification Number (EIN)
*
Your answer
IRS 501(c) type ( i.e. 501(c)3, 501(c)4, …501(c)28)
*
Your answer
Has your organization been operating for at least 2 years ?
*
MDEM requires all participating organizations to be operating for a minimum of 2 years prior to participate in the NPEP. If your organization or group has not meet this criteria, please email
npep.mdem@maryland.gov
for additional assistance.
Yes
Organizations start date
*
MM
/
DD
/
YYYY
Does your organization have a physical location?
*
Yes
No
Organization Mailing Address
*
Please include the City, State, Zip code, and Suite, Floor, or Unit number/s if applicable (P.O. Boxes are also acceptable). Please write "N/A" if you answered "No" to having a physical location.
Your answer
Mission/ Focus Area
*
Your answer
Primary Point of Contact Name (First and Last)
*
Your answer
Primary Point of Contact Email Address
*
Your answer
Primary Point of Contact phone number (please do not include dashes in the number)
*
Your answer
Secondary Point of Contact Name (First and Last)
Your answer
Secondary Point of Contact email address
Your answer
Secondary Point of Contact phone number
Your answer
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