!

Founded 1938

Improving the quality of life for African American Women, Families and Communities
Dr. Mary McLeod Bethune, Founder Ingrid Saunders Jones, Chairman of the Board Kruzshander Scott, President

MEMBERSHIP APPLICATION
(FRONT)

The Jacksonville Section of the National Council of Negro Women is working to improve the quality of life for women, their families and communities, especially those of African American heritage. NCNW is part of a coalition of national mens and womens organizations united for strength and committed to the support, service and advocacy of all people. Our members come from every walk of life and range in age from students to retirees. Whatever the stage of life or age, our members have one primary thing in common they are united in common task for the welfare of others. If you share this commitment, we invite you to join in the work to find solutions to problems of human welfare, human rights, social planning and action on the local, national and international level through community projects, programs and initiatives that focus on issues of health, education, and economic empowerment and so much more.
(Please complete all fields and print legibly)

Name: ! Membership ID (for renewing members): Address: ! City: ! Phone: E-Mail: ! New Member Section Name: Jacksonville Florida Section ! I am joining as a Direct Member, my Affiliate Name is:
(Please call for more information)

State: Cell:

Zip:

! Renewing Member!

Membership Dues: NCNW members are required to pay local dues as defined by local section bylaws, and national dues as defined by the NCNW constitution and bylaws. Annual dues support the work and programs of the NCNW National Office and their local Sections. Dues are due and payable by January 1 of each year. Local dues are not prorated. Method of Payment: ! Check or Money Order
(Payable to NCNW)

! Visa Credit Card

! MasterCard Credit Card

Credit Card Account Number: Expiration Date: Signature: Amount:

Founded 1938

Improving the quality of life for African American Women, Families and Communities
Dr. Mary McLeod Bethune, Founder Ingrid Saunders Jones, Chairman of the Board Kruzshander Scott, President

MEMBERSHIP APPLICATION
(BACK)

Membership Types: Current individual membership options are outlined below with applicable national and local dues and membership amenities or features listed. Additional Life (Group) and contributing memberships (Partner, Advocate and Leadership Circle) are available through the national office. Membership Type
(Check Only One)

National Dues $2.00 $10.00 $30.00 $30.00 $500.00! $1000.00!

Local Dues $13.00 $15.00 $50.00 $50.00 $60.001 $60.001

Total Dues $15.00 $25.00 $80.00 $80.00 $500.002 $1,000.002

! Youth Division (13-18 years of age)

Newsletter

! Student Membership (Collegiate)

Newsletter

! Annual Membership
Newsletter

! Associate Membership (Men)

Newsletter

! Life (Individual) ! Life (Legacy)

!One-time national dues.
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Newsletter with Name Recognition and Jeweled Silver Lapel Pin. Newsletter with Name Recognition and Jeweled Gold Lapel Pin.

Determined by Life Members Division of NCNW Jacksonville Section. First year dues payment. Ongoing dues are paid to local Section as determined by Section bylaws.
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! The national office traditionally provides membership amenities, but the local Section may provide limited options as well. All memberships are annual memberships, except Life memberships, which may be a one-time or incremental payment. Life membership annual dues support local programs and initiatives. Annual dues are determined and assessed in accordance with local section bylaws. Please return the completed application along with payment to: Jacksonville Section, National Council of Negro Women (NCNW) P.O. Box 2583 Jacksonville, FL 32203-2583 If you have any questions regarding membership, email jaxncnw.membership@yahoo.com. You can also visit us on our social media pages on Facebook at www.facebook.com/ncnwjax and on Twitter at www.twitter.com/jaxncnw. The NCNW is a 501(c)(3) tax-exempt charitable organization. Donations and dues are tax deductible as allowed by law.

JAXMBRAPP2014