âYouth. Select your membership category: Women: âAnnual $40 â Life $500 â Legacy Life $1000. Men: âAssociate $
Northern Virginia Section of the National Council of Negro Women Annual Membership Enrollment Form
Join now and become part of the legacy! Please Print Clearly Date: Salutation (Ms. Miss, Mrs., Mr.): First Name: Middle:
Last Name:
Mailing Address: City: E-mail: Telephone: Status: ☐ New Member
State:
Zip:
Cell: ☐Renewing Member Member ID (renewing members only):
Special skills: Committees: (Please select one or more) ☐Audit ☐Bethune ☐Bylaws
☐Cheerios ☐Education ☐Fashion Show
☐Finance ☐Health ☐Hospitality
☐Legislative ☐Membership ☐Nominating
☐Outreach ☐Programs ☐Publicity
☐Technology ☐Ways & Means ☐Youth
Select your membership category: Women: ☐Annual $40 ☐ Life $500 ☐ Legacy Life $1000 Men: ☐Associate $40 ☐ Associate Life $500 ☐ Youth $2 ☐ Student $10 ☐ Partner: $50 ☐ Advocate/Sponsor $75 ☐ Leadership Circle $150 ☐ Group Life $750 Make your check payable to NoVA NCNW (SAV003). Please mail the completed form with payment to NoVA Section SAV003 NCNW, P. O. Box 119, Merrifield, VA 22116. Total Payment:
Check Number:
Signature: How did you hear about NoVA Section? ___________________________________________________ NoVA Section of NCNW is a 501(c) (3) organization. For more information send email to
[email protected] or visit our website www.novancnw.org.
Welcome!
