Kalamazoo Chapter 2021 Membership
This form collects the necessary information for your membership in the Kalamazoo NFB chapter (a chapter of the NFB of Michigan). As a member, you are entitled to vote, run for office and attend all meetings of our capter.  

You can use this form to become a member for $5, at any time before our next meeting, which will be January 11, 2021. You must be a member to participate in the elections to be held that date, or to run for a position.

Payment is accepted by:
Paypal: http://www.paypal.me/kzoonfbmi/5
Cash App: $KzooNFBMI
Apple Cash, Credit card or none of the above forms of payment: Send/call/Text (269) 358-8853

Additionally, You must fill out this form, since the NFB requires us to collect certain information about our members.

PLEASE NOTE: This is the first step in completing your registration, you will still need to complete the second step of paying dues before your membership is finalized. We need both a payment and this form. Thank you.
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Please enter your first name *
Please enter your last name *
Home Email address: *
Work Email address (leave blank if you do not have one):
Street Address: *
Additional Address Information (i.e. Apartment, Suite, c/o), if applicable:
City: *
State (2 Letter Abbreviation): *
Zip: *
Home Phone Number - leave blank if you do not have one (enter 10 digits, with no spaces or punctuation):
Mobile Phone Number (enter 10 digits, with no spaces or punctuation): *
Work Phone Number - leave blank if you do not have one (enter 10 digits, with no spaces or punctuation):
What year did you first join the NFB as a member? *
Are you blind? *
Do you use a cane? *
Do you use a dog guide? *
What is your preferred format for receiving communication? *
Date of birth: *
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Notes or Comments (is there anything else you would like us to know about you)?
Please choose "I Agree" to continue. By checking this box, you agree that you will complete your registration by paying your dues by Paypal, Cash App or by contacting the treasurer as mentioned above. Your membership will not be active until both this form and payment are received, and form information has been validated. *
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