Membership Application

THE NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE
“The largest and most respected Civil Rights Organization in America”

Membership Application

Unit 6220 – San Antonio Branch NAACP

• Today’s Date:
  
  
• Name:
  
  
  First
  
  
  
  Last
  
• Address:
  
  
  Street Address
  
  
  City
  
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  State
  
  
  ZIP Code
  
• Primary Phone:
• Business Phone:
• Fax:
• Payment Method:
  • Online via PayPal
  • Check
  • Money Order
• Check Number:
• Money Order Number:
• Solicitor:

• If paying by Check or Money Order Mail Payment to:

  NAACP
  P.O. Box 200225
  San Antonio, TX 78220-0225
  

• Membership Desired

• Please Check One (Regular Membership includes 1-year subscription to Crisis Magazine)

• Regular Annual Membership (Option)

• Regular Annual Membership
  • Regular Adult – $30.00
  • Youth (up to 21) -(With Crisis Magazine) – $15.00
  • Youth (up to 21) -(Without Crisis Magazine) – $10.00
  • Annual Corporate Membership – $5,000.00
  • WIN (Women In NAACP) – $10.00
  • None – $0.00

• Lifetime Membership (Option)

• Junior Life (Ages 13 and Under) – $100.00Payable in annual installments of $25.00 or more –
  (you enter the desired amount)
  
• Bronze Life (Ages 14 to 21) – $400.00Payable in annual installments of $50.00 or more –
  (you enter the desired amount)
  
• Silver Life – $750.00Payable in annual installments of $75.00 or more –
  (you enter the desired amount)
  
• Gold Life – $1,500.00Payable in annual installments of $150.00 or
  more after completing Silver Life Membership –
  (you enter the desired amount)
  
• Diamond Life – $2,500.00Payable in annual installments of $250.00 or
  more after completing Gold Life Membership –
  (you enter the desired amount)
  
• Total Membership Amount Due:
  $0.00
  

• eSignature

• By typing my name below I am stating that this will be used as my electronic signature.
• eSignature: