JOIN THE FIGHT FOR FREEDOM JOIN THE FIGHT …

JOIN THE FIGHT FOR FREEDOM JOIN THE FIGHT
                                      Join the
FOR FREEDOM JOIN THE FIGHT FOR FREEDOM JOIN
THE FIGHT FOR FREEDOM JOIN THE FIGHT FOR
FREEDOM JOIN THEFOR
          FIGHT FIGHT FOR FREEDOM JOIN THE                              FREEDOM
                                     DURING OUR MEMBERSHIP CAMPAIGN
                                      Membership is the life-blood of the NAACP. We depend on our members' generosity to insure
                                      the NAACP's independence. We depend on you to keep the flames of freedom burning bright!

 1 MEMBER INFORMATION (please print clearly)
 s Mr.     s Mrs.      s Ms.      s Miss      s Other                                                                       Date


 First Name                                             M.I.   Last Name


 Address                                                                                                                                     Apt./Suite


 City                                                                                                                              State     Zip


 Unit Affiliation                                                             Current Membership No. (if renewal)


 Phone No.                                    Email Address
 Are You A Registered Voter? s Yes s No
                                                                 Solicitor's Name
 Campaign ____________________________________
 2 MEMBERSHIP TYPE (please check one)
              REGULAR ANNUAL MEMBERSHIP                                                            LIFETIME MEMBERSHIP
  s Regular Adult (Ages 21 & older) . . . . . . . . . . . . . . .$30*          s Junior Life (Payable in annual installments of $25 or more) . . . . . .$100**
  s Youth with Crisis Magazine (Ages 20 & under) . . .$15*                        (Ages 13 & under)         /      /      Date of Birth

  s Youth without Crisis Magazine (Ages 17 & under) .$10                       s Bronze Life (Payable in annual installments of $50 or more) . . . .$400**
                                                                                 (Ages 14-20)        /      /      Date of Birth
  s Annual Corporate . . . . . . . . . . . . . . . . . . . . . . . .$5,000*
                                                                               s Silver Life (Payable in annual installments of $75 or more) . . . . .$750**
  * Includes a 1-year subscription to The CRISIS Magazine
  ** Fully-paid Life Memberships include a 10-year                             s Gold Life (Payable in installments of $150 or more) . . . . . . . .$1,500**
     subscription to The CRISIS Magazine                                         Only available to Silver or Regular Life Members
  $
   6.00 per year of the membership fee will be applied                         s Diamond Life (Payable in installments of $250 or more) . . . . .$2,500**
  toward your subscription to THE CRISIS                                         Only available to Gold or Golden Heritage Life Members

 3 PAYMENT
 Amount Paid $ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
                _________________                    s MasterCard                s VISA                 s American Express                   s Cash
 Credit Card Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ s Check (checks and money orders should be made payable to: NAACP)
                      __________________________________
 Name as it Appears on Card _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
                                  ____________________________                                           _______________________
 Authorized Signature _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Or Pay by Credit Card Online at: www.NAACP.org
                       _________________________________

                    THANK YOU FOR YOUR SUPPORT