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MEMBERSHIP APPLICATION

NAME: _______________________________________________________________

ADDRESS _____________________________________________________________

CITY ____________________STATE ________________ ZIP CODE ______________

HOME TELEPHONE _____________________________

EMAIL _________________________________________

My signature below is evidence of my agreement to abide by and be bound by the rules

and regulations of NPBA.

SIGNATURE: ___________________________________ DATE: _________________

MEMBERSHIP FEES:

Adult membership: $40 Youth membership $25

(18 and under as of January 1, 2009)

NEW: Membership will now be for a twelve month period and will be effective the first

day of the month the membership application is received in the NPBA offices ( for

example, if membership is received on February 8, 2009, membership expires on January

31, 2010). All exhibitors at NPBA sponsored events must be NPBA members.

Please return form and check for membership fee to the address set forth above.

______________________________________________________________________

OFFICE USE ONLY: