Agency Membership Membership in The Daly City Partnership is available to any agency or organization that is a “recognized provider of services for children, youth, adults or families”. Agency Name: Type of Service Provided: Agency Address: City: State: Zip: Designated contact / voting member: Job Title: Additional Agency Representatives to Receive DCP Membership Cards: (List names / email): E-Mail: Particular Interests(Please check all that apply) Child Care Adult Literacy School Readiness Programs After School Activities Teen and Youth Programs Elder Programming DCPPC Leadership or Volunteer Opportunities Promoting Healthy Lifestyles Intergenerational Collaboration Transportation Housing Safety / Crime Prevention Other - (Specify): Other - (Specify): Annual Agency Membership Fee Structure Sponsor Level:$150 (annual budget of more than $250K but less than $1M -plus 3 staff membership cards) Patron Level:$175 annual budget of more than $1M -includes 4 staff membership cards) Benefactor Level:$300 annual budget of $2M -includes 5 staff membership cards) Additional Donation Option:Specify Amount (Donation supporting DCP programs & services benefitting children, youth, families & seniors.) Membership/Donation Sponsor $150 USD Patron Level $175 USD Benefactor Level $300 USD Additional Donation Option Specify Additional Donation Amount: $