NAAFA, INC. P. O. BOX 188620 SACRAMENTO, CA 95818 916/558-6880 - HTTP://WWW.NAAFA.ORG Application also found at http://www.naafa.org/documents/brochures/subscription_form.html

Name: ______________________________________________________________ Birthday: ___/___ (Month/Day)

Address: ____________________________________________________________E-Mail: _______________________

City: ___________________________________ State: _____ Zip Code: ______Phone: _______________________

PLEASE ACCEPT MY APPLICATION AND PAYMENT FOR THE FOLLOWING (check one):

• Regular=40/yr
• Sustaining*=$60/yr
• Supporting*=$100/yr
• Student, Senior, Limited Income=$25=39/yr
• Outside North America – Regular=$50/yr Joint Resident=$20/yr (for each additional member at the same address);
• Benefactor*=$250/yr; Philanthropist*=$500/yr
• Auxiliary=$10/yr (Add$10 for each member’s child under 18. Maximum $20 for families with more than two children. No voting privileges.); Name(s)________________________________________________________________
• Amount Paid: $__________

REFERRED BY CHAPTER 520—CAPITAL CHAPTER OF NAAFA

Individual and joint members of Capital NAAFA need to be members of NAAFA, INC.

Dues include bi-monthly newsletter and discounts at NAAFA, Inc. functions. ENCLOSE CHECK OR MONEY ORDER, VISA OR MASTERCARD NUMBER, EXPIRATION DATE & SIGNATURE to address above. *New Sustaining,Supporting, Benefactor, and Philanthropist members will receive a complimentary copy of the NAAFA Workbook, an introduction to size awareness. Memberships fees over $40 are tax-deductible to the fullest extent of the law.

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