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NETWORK NATIONAL Membership Application
ANNUAL NATIONAL MEMEBERSHIP FEE: $50
You may pay online or make check payable to:
NETWORK NATIONAL
PO Box 44711
Washington, DC 20026-4711
Email questions to
thenationalnetwork1983@gmail.com
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DATE:
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MM
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YYYY
NAME
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HOME ADDRESS (City, State, Zip Code +4)
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PHONE NUMBER
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EMAIL
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USPS POSITION/TITLE/ LEVEL
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CHAPTER AFFILIATION
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RECRUITED BY
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BIRTHDAY
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DD
TEE SHIRT SIZE
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EMERGENCY CONTACT
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PAYMENT METHOD
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ONLINE
CHECK
OTHER
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Are you interested in serving on a NETWORK Committee?
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WHICH NETWORK Committee? (Select Below)
Agenda
Fundraiser
Special Events
Constitution & By-Laws
Finance
Membership
Strategic Planning
Scholarship
Training / Development
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