CaringBridge / CaringBridge Alliance Application

Submit Alliance Application and Agreement

Thank you for your interest in providing CaringBridge as a service to your community and helping us build awareness. We are grateful for your support.

Please complete the application below and submit your request if you agree to the terms and conditions specified, and are an organization that has been established for at least one year. Or, you may print, fill out and mail this application and agreement. A CaringBridge representative will contact you within three business days to learn more about your organization and answer any questions you have and assist you in your program launch. For help with technical questions, contact Customer Care.

Organization Information

* Required field.

*Organization Type:
*Organization Name:
*Tax Status:
*Registered 501(c)(3):: No
Yes
*Site URL:
Address:
City:
*State/Province:
Postal Code:
*Country:
Organization Description & Comments:

Your Contact Information

*First name:
*Last Name:
Job Title:
*E-mail:
*Phone:

: Yes, I have read and agree to the Alliance Terms and Conditions

We may reject your application if we determine (in our sole discretion) that your site is unsuitable for the Program. If we reject your application, you are welcome to reapply to the Program at any time. You should also note that if we accept your application and your site is thereafter determined (in our sole discretion) to be unsuitable, we may terminate the Agreement. Participation in the Program is limited to parties that lawfully can enter in to and form contracts under applicable law. For example, minors are not allowed to participate in the Program.