Membership

Please join the Jeffersonville/Clark County NAACP Branch.  For more information, contact Fay Allen, Membership Chairperson at (812) 282-3127 (after 6pm only).

Please print this page, fill it out, and return with payment to:

Jeffersonville/Clark County NAACP Branch
Attn: Fay Allen, Membership Chairperson
PO Box 783
Jeffersonville, IN 47130

MEMBERSHIP APPLICATION

Name___________________________________________

Title____________________________________________

Organization_____________________________________

Address_________________________________________

City, State, Zip___________________________________

Phone____________________Fax____________________

Membership Fee (please indicate):

___Regular Adult Membership ($30 Annual)
with Crisis Magazine subscription

___Subscribing Life Member ($75)
with Crisis Magazine subscription (for 10 payments)

___Youth Membership ($15 Annual)
Member under 21 with Crisis Magazine subscription

___Basic Youth Membership ($10 Annual)
Member under 21 without Crisis Magazine subscription

___Corporate ($7500)