National Association of Black Narcotic Agents

Annual Membership Dues Renewal/New Membership

(January 1, 2010 thru December 31, 2010)

 

 

Date_________________

 

 

Remit form and check to:  NABNA, P.O. Box 7012, Metairie, LA  70010 or visit the NABNA Website; www. nabna.org, pay online with “Click and Pledge,” then mail in your dues form.

 

 Name ________________________________________

 

Address_______________________________________

            

             _______________________________________

 

            ________________________________________

 

E-Mail Address _________________________________

 

 

 

New Membership

$100.00    _________

Membership Renewal 

$125.00    _________

LATE FEE (If currently financial and/or remitted between February 1, 2010 and May 31, 2010) 

$5.00        _________

REINSTATEMENT FEE (If not currently financial and/or remitted after May 31, 2010)

$10.00      _________

ASSOCIATE MEMBERSHIP   

 $50.00     _________

SCHOLARSHIP FUND DONATION (Tax deductible)     

$              _________

 

Grand Total $__________