Apply for your group to become an affiliate

This page includes the webform to submit an application for your group to become a Secular Woman branded affiliate.
(1) A representative of the group is asked to include information on behalf of the group, including a second contact person. Fields marked with an asterisk* are required.
(2) Please read the "Terms of Agreement" (see below for link; a PDF document will open in a separate window). If you agree, please click the "I agree" box below.
(3) A member of Secular Woman will be in touch with the representative once the application has been reviewed. 

Enter first name for the group contact.
Enter last name for group contact
Email address for the group contact
Sample: 234-345-4567
Please provide the Secular Woman Affiliate name your group is requesting, such as "Secular Woman Omaha," "Secular Woman of the Tri-Cities," or "Springfield Secular Woman."
If your group currently exists under another name, please provide it here.
I have read the terms of agreement and agree to the Secular Woman Affiliate Conditions on behalf of my group.
If your group has an additional person whom we may contact with, please include here.

Secular Woman, Inc. is a non-profit, 501(c)(3) public charity. All donations and gifts made are tax-deductible to the full extent allowed by law.

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