(This form can be printed. Once you have completed the information, please mail it with your check or money order to the Monroe County Branch NAACP address listed below.)
MONROE COUNTY BRANCH NAACP MEMBERSHIP FORM "Join The Fight For Freedom" Please Print Date:
____________________
Mr. / Mrs. / Ms.:
________________________________________
Street Address:
________________________________________
City, State Zip:
________________________________________
Branch Affiliation:
________________________________________
Current Membership Number (renewal): ________________________________________
Regular Annual Membership
Lifetime Membership
[ ] Regular Adult
$30
[ ] Junior Life $100 (birthdate __________)
[ ] Youth with Crisis
$15
[ ] Bronze Life $400 (birthdate __________)
[ ] Youth without Crisis $10
[ ] Silver Life
$750
[ ] Annual Corporate
[ ] Gold Life
$1,500
[ ] Diamond Life
$2,500
$5,000
Check Number: __________
Amount: __________
MAILING INFORMATION PLEASE MAKE CHECKS PAYABLE TO NAACP Thank you for your support. Membership Monroe County Branch NAACP P.O. Box 243 Bloomington, IN 47402-0243 Please save a copy of this completed form as your receipt.
Diamond Life. $2,500. Check Number: ______. Amount: ______. MAILING INFORMATION. PLEASE MAKE CHECKS PAYABLE TO NAACP. Thank you for your support. Membership. Monroe County Branch NAACP. P.O. Box 243. Bloomington, IN 47402-0243. Please save a copy of this completed form as your receipt.
Sep 15, 2015 - Page 1 ... interstate, go through an airport, or even enter into our own homes ... act now to build trust between law enforcement and the .... Thank you in advance for your attention to my concerns; we look forward to hearing ...
Sep 15, 2015 - challenged when we cannot walk down the street, drive down an interstate ... practice, but it also prohibits profiling and collects data to fully ... The majority of law enforcement officers are hard working men and women, whose concer
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These forms can also be delivered to the OBSID office in 21 Lower Main Road or to the Library in Station Road. You can also scan the completed form and email ...
opportunities overseas or, where required, to enable the IET to meet any legal or other legitimate obligations in that country. IET products and services are ...
two individuals at the same address. (Can be spouses or parent and child.) Renewals are due by January 31 each year. Please print this form and sub- mit with your dues. Please print information or use address label where ap- plicable. Members receive
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Date received. Payment received. Accepted/Declined. Election date. Page 2 of 2. Junior Membership Form 2017.pdf. Junior Membership Form 2017.pdf. Open.
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Bank: Commonwealth Bank ; Account Name: Free West Papua Party Association Inc;. BSB: 066 128; Acct: 1069 1517; Please put your First Name & Surname in ...
Home Country/State: Undergrad ... Musical Director and the committee, and that failure to pass an audition will result in the termination of membership. Should.
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Canadian Shooting Sports club level handgun safety course OR show proof of having taken the. course OR have IPSC, IDPA PPC credentials. Contact: Ken ...
Cheques etc should be made payable âA/C Eagle ACâ and crossed. Or.......pay directly to: âEagle Track Clubâ account: 66 South Mall, Cork Sort Code: 93-63-83 A/C: 12656023. â and please use a narrative, with your name.....so we know whose fe