Join NAACP of Oak Ridge !

PLEASE SELECT A MEMBERSHIP:

Adult Memberships    Regular Adult   Ages 21 & older        $30  Prison  Includes The Crisis Magazine        $12  Silver Life          Payable in annual installments of $75 or more      $750  Gold Life  Payable in annual installments of  $150 or more    $1,500   Diamond Life  Payable in annual installments of $250 or more    $2,500   Annual Corporate  Includes 1-year subscription to The Crisis    $5,000
Youth Memberships * Youth (w/o Magazine)    Available to individuals ages 20 and under          $10  Youth (w/ Magazine)  Available to individuals ages 20 and under       $15   Junior Life Membership  Available to individuals ages 13 and under.                                 Payable in 8 annual installments of $50.00 or more.    $100  Bronze Life Membership  Available to individuals ages 14 to 20.   Payable in 8 annual installments of $50.00 or more.    $400         * Date of Birth  Required for Youth Memberships

Member Information
Please enter the following information, as you would like it to appear on your membership card.

**  Required       ++  Optional

Salutation (circle one)** Mr.      Mrs.     Miss.    Ms.    Dr.   Rev.
First Name **_________________ Middle Initial ___________
Last Name **_________________ Lineage (Jr., Sr.) ____
Suffix (Degrees) ________________
Mailing Address: **_________________________
City: **______________________
State/Province *____________
Country: ** ___________________
E-mail: _______________________________
Phone (Day): ++ ________________________ Phone (Evening):  ++ ____________________
Fax:  ____________________________
Unit Affiliation:  ________________________  Current Membership No. (if renewal) ________________________
Registered Voter? [ ]Yes       [ ]No
Print this form, complete and mail with check or money order (payable to NAACP) to: NAACP of Oak Ridge P.O. Box 6165 Oak Ridge  TN 37831-6165