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ISWFACE MEMBERSHIP INFORMATION AND APPLICATION FORM PRIVATE AND CONFIDENTIAL PAGE #1 |
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ISWFACE MEMBERSHIP INFORMATION AND APPLICATION FORM PRIVATE AND CONFIDENTIAL PAGE #1 |
Download pdf application
version ws 06/04.03
WHO IS ELIGIBLE: Membership in the Foundation is limited to [a] those individuals and organizations who fully support the right of the sex worker to self-determination, to have the right to choice, to work in a non-coercive environment, be the coercion at the hands of another individual or government in the form of prohibitive or undue/uncalled for regulations and restrictions, and a belief that sex work is not in and of itself a form of coercion or inherently degrading (b) current, ex and transitioning sex workers, sex worker activists and known supporters and allies of sex workers. If you have any questions about your eligibility, please don't hesitate to e-mail, write or call us. You may be required to provide references. Only current or ex-sex workers will
have voting privileges to ensure the continued pursuit of the goals
of the founders. AFTER YOU DOWNLOAD THIS
QUESTIONNAIRE, PLEASE PRINT OR TYPE CLEARLY AND MAIL WITH YOUR
MEMBERSHIP FEE TO: ISWFACE Today's Date____________________________________________________ Name___________________________________________________________________________ Is this an alias? _____yes _____no
[note, if you are a sex worker using an alias, the US tax laws
require that you provide us with your legal name if and when you
apply for funding.] If applying as an organization, name of organization:___________________________________ Age?______________ [You must be
at least the age of consent within the country in which you reside
when applying for funding] Mailing Address_________________________________________________________________ City ______________________ State or Province_____________________________________ Country_______________________ Postal/zip code___________________________________ Telephone number(s)_____________________________________________________________ Fax number_____________________________________________________________________ e-mail address__________________________________________________________________ web site address________________________________________________________________ Are you (check all that apply):
____ a current, ex or transitioning
sex worker? ____ researchers [type of
research] ____ academic [specify
field] ____ legal expert [specify field
of expertise] ____ health or social worker
[specify] ____ other (please
specify)_________________________________________
All membership requirements, list of
incentives for each membership level and other relevant information
may be found in the ISWFACE Handbook. Individual Membership
Fees* Yearly Yearly ___ Level I $25 ___ Level III $100 ___ Level II $50 ___ Level IV $150 and up ___ I do not wish to join at this
time, but I am enclosing the following (tax deductible)
contribution____________ We encourage you to subscribe at the
highest level you can afford. Please consult your handbook for
further information regarding membership benefits. *Organizational memberships are still
under review and fee structure will be determined at a later
date. No current, ex or transitioning sex
worker will be denied membership solely because they cannot afford
membership fees. Special consideration, including waiving all fees if
necessary, will be given to sex workers in developing countries and
incarcerated sex workers. [ This offer is not available to
non-sex workers. See waiver qualification details further in this
application form] ____________________________________________________________________________________ FOR ALL - SIGNATURE REQUIRED TO
PROCESS APPLICATION By signing this document I hereby
acknowledge that I support the right of the sex worker to
self-determination, to have the right to choice, and to work in a
non-coercive environment, be the coercion at the hands of another
individual or government in the form of prohibitive or unfair
regulations and restrictions. I also hereby agree to accept and abide
by the conditions of membership as stated in the Handbook. SIGNATURE _____________________________________date______________________________________
ISWFACE is a non-profit public benefit corporation. A
substantial portion of your membership fees may be tax-deductible
(refer to your local tax regulations).
8801 CEDROS AVE. #7, PANORAMA CITY, CA 91402 USA
ISWFACE MEMBERSHIP APPLICATION FORM- continued page # 2
Version ws06/04.03
___ In addition to my membership fees,
I am also enclosing the following (tax deductible)
contribution_________
Method of payment and where to send:
* We accept checks and money orders (US currency only), and Paypal.
*Checks and money orders should be payable to: ISWFACE and mail to:
8801 Cedros Ave. #7, Panorama City, CA 91402 USA [phone/fax:(818) 892-8109]* I am enclosing:
___ check ___money order [we cannot accept credit cards at this time]
If you are requesting a waiver of
membership fees, please attach a separate page with a brief
explanation. Each request for waiver will be evaluated on a case by
case basis. If no explanation is attached, we cannot consider your
request. ____ I am requesting a temporary
waiver _____I am requesting a permanent waiver
OPTIONAL QUESTIONS: CURRENT, EX
and TRANSITIONING SEX WORKERS ONLY While it is not a requirement to
respond to the following questions, your honest answers will assist
us in achieving the goals of the Foundation. ________ ______ ________ _______
_______ ________ ________ ________ _________ [1] Do you identify as: ____
transgender ____female ____ male [2] In what type of sex work
are or were you employed?
[3] Do you participate in any
of the following creative activities? If so which ones? Please check
all that apply: ____ Artist- painter sculptor fine
art photographer craftsperson cartoonist graphic artist ____ Film Maker/ including
documentary films and videos ____ Musician: singer composer
instrumentalist (type of instrument) ________________ ____ Performance Artist Comedian
Dancer ____ Poet ____ Writer: fiction non fiction
(other than academic works on prostitution) ____ Other: explain [4] (a) Has your creative
work ever been: ___ publicly displayed, exhibited or
performed ___produced for public distribution ___ published, printed, or reproduced
in any currently available medium (b) If so, please give details and
dates, on separate page if necessary ________________________________________________________________________________ ________________________________________________________________________________ [5] (a) Have you ever applied for funding, grant money or scholarships for your creative projects? (b) Did you receive
funding/grant/scholarship?* (c) If application(s) was or were
rejected, what were the reasons given?* Use separate page if
necessary. ________________________________________________________________________________ ________________________________________________________________________________ * Answering these questions will
NOT effect any future application for funding from
ISWFACE [6] (a) What are your
computer skills? ____none ____limited ____expert (b) Please list any computer, scanner, fax, video camera and other communication technology equipment you have available to use________________________________________________ _________________________________________________________________________________ (c) Are you on the internet or do you
have access to the internet?________________________ [7] (a) Do you belong to a sex worker organization?____________________________________ (b) Name of organization?_________________________________________________________ (c) Is there a sex worker support/
advocacy organization in your community?*______________ (d) If so, which one______________________________________________________________ (e) If not, what is the nearest organization to your community?___________________________ * If you are unaware of any
organizations in your region, we will try to locate one for you if
you are interested [8] What services and
programs offered by ISWFACE interest you the most? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ [9] Do you have access to HIV/AIDS and safe sex programs or information and counseling service providers, if so which ones?_________________________________________________________________________
AND ALL INFORMATION CONTAINED
HEREIN IS FOR ISWFACE USE ONLY. UNAUTHORIZED VIEWING OF THESE FORMS
IS A VIOLATION UNDER SEVERAL UNITED STATES FEDERAL AND STATE LAWS,
AND VIOLATORS WILL BE PROSECUTED TO THE FULLEST EXTENT OF THE
LAW.
Database entry_________
date_____________ by______________
WAIVER OF MEMBERSHIP FEE REQUIREMENTS:
ISWFACE MEMBERSHIP APPLICATION FORM - continued page #3 Version ws06/04.03
ALL ISWFACE MEMBERSHIP APPLICATION FORMS ARE CONFIDENTIAL
ISWFACE use only. Do not write in this area
