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:
Received by: ________________________ Date:
_________________________