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Coming Clean membership information
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Your First Name(s) *
Your Last Name(s) *
Please share your pronouns:
Type of Membership
The default way to join the Coming Clean network is through an "Organizational Membership." Organizations that are members of the Coming Clean network are able to have their staff/volunteers participate in our collaborative teams and initiatives, initiate collaboration with other members, and utilize our shared collaborative spaces online and in-person.

In rare cases, it makes sense for an individual who is not affiliated with an organization or whose organization couldn't be a Coming Clean member (for example a hospital or university) to join the network through an "Individual Membership." EJHA affiliates are welcome to join the network through their affiliation with EJHA or their organizational affiliation.
Please select your type of Coming Clean membership: *
May we share publicly that your organization is a member of the Coming Clean network (for example on Coming Clean's webpage)? *
Your Organization or Affiliation *
Your Job Title or Role *
Your Phone Number *
Your Email Address *
Physical Address where you can receive packages (this is not shared in the directory or with any third party, but we use it to make sure your Coming Clean swag gets to the right destination) *
City *
State *
ZIP / Postal Code *
Country *
Is there anyone else from your organization who should also be connected to the network? If so, please list name and email address.
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