Vitalyst Membership Scholarship Application

AZ Impact for Good strives to ensure membership is accessible to all nonprofits, regardless of size, location or ability to pay. Thanks to Vitalyst Health Foundation, we are able to provide membership scholarships for qualifying organizations while funds remain.

To receive a 'Vitalyst' scholarship, your organization must not have been a member of AZ Impact for Good within the last five years and meet one (1) of the following qualifications to apply.

Organizations who have an annual budget of under $500,000, show financial need, and fall within Vitalyst’s Elements of a Healthy Community parameters.
Organizations who are an existing Vitalyst partner (a grantee or recipient of consultation support)

Once approved, the attendee will receive an email with instructions on how to secure their membership online.

Opportunities may be limited depending on available scholarship funds. Please complete one form per organization.

Fields marked with an * are required.

Company/Organization Name *

First name *

Last name *

Job Title

Email *

Office Phone *

Mailing Street Address *

Mailing City *

Mailing State *

Mailing Zip Code *

County *

Are you an existing Vitalyst Health Foundation grantee or recipient of consultation support? *

Yes

Has your organization been a member of AZ Impact for Good (formerly Alliance of Arizona Nonprofits)? *

What is your most recent annual organizational annual revenue? *

Does your organization fall within Vitalyst's Elements of Healthy Community? *

Find more information here.

Yes

Briefly share what 'elements' your organization qualifies under?

Find more information here.

Full-Time Employees *

Primary Mission Type

Additional Comments

Please verify that you have checked the “I'm not a robot” checkbox.