Membership Form

Please print and fill out the form below and return it through mail to: New Brunswick Area NAACP, P.O. Box 235. New Brunswick, NJ 08903-0235.  You can also call the NAACP hotline at: 732-828-5363. Please make checks payable to the: New Brunswick Area NAACP.

NAACP MEMBERSHIP FORM
From the New Brunswick Area Branch of the NAACP

Date______________

Mr./Mrs./Ms.: ________________________________________________________

Street Address: ____________________________________________________

City: _______________________________ State: ______ Zip: ________

Branch Affiliation:  #2094 -New Brunswick Area Branch

Date of Birth: ____________________________________________________

Current Membership No.(If Renewal)___________________________


Type of Membership
(Check desired membership.)

Regular Annual Membership
_______Regular Adult  ……………………………………. $30.00
_______ Youth with Crisis…………………………………. $15.00
_______ Youth without Crisis ……………………………..$10.00
_______ Annual Corporate ………………………………..$5,000.00

Lifetime Membership
______ Junior Life (ages 13 and under) ……………….$100.00
______ Bronze Life (ages 14 to 21) ……………………$400.00
______ Silver Life ……………………………………………$750.00
______ Gold Life …………………………………………….$1,500.00
______ Diamond Life………………………………………..$2,500.00

Thank You for your Support.
Gifts and contributions to this NAACP Branch are not tax deductible as charitable contributions. However, a portion of your dues is passed on to the NAACP National Organization and these payments are tax deductible.

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