Join - NAACP Kansas City

Membership Application

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!

New applicants and existing members complete the form below.

Membership Application

Date *

Solicitor's Name

Unit Number/Name

Do you wish to affiliate with your local unit?

Campaign

Salutation

Other:

First Name *

M.I

Last Name *

Phone # *

Email Address *

Are You a Registered Voter?

Membership Type

Address

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Country

Country

Payment Option

Credit Card

Important Tax Information

Membership Type	Full Payment	Affiliated Tax Deductible Amount	At-Large Tax Deductible Amount	Subscribing Payment	Affiliated Tax Deductible Amount	At-Large Tax Deductible Amount
Regular Adult	$30.00	$11.85	$24.00	n/a	n/a	n/a
Youth w/ Crisis	$15.00	$10.20	$9.00	n/a	n/a	n/a
Youth w/o Crisis	$10.00	$5.70	$10.00	n/a	n/a	n/a
Annual Coporate	$5,000.00	$2,994.00	$4,994.00	n/a	n/a	n/a
Junior Life	$100.00	$54.00	$94.00	$25.00	$9.00	$19.00
Bronze Life	$400.00	$234.00	$394.00	$50.00	$24.00	$44.00
Silver Life	$750.00	$390.00	$690.00	$75.00	$39.00	$69.00
Gold Life	$1,500.00	$840.00	$1,440.00	$150.00	$84.00	$144.00
Diamond Life	$2,500.00	$1,44.00	$2,440.00	$250.00	$144.00	$244.00

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