NAACP - St. Petersburg Branch (5130) Membership Application

ST. PETERSBURG BRANCH NAACP (5130)

P.O. Box 35123 - St Petersburg, FL 33705
MEMBERSHIP IS POWER!

Please join the NAACP today. Thank you.
MEMBERSHIP APPLICATION

(NEW/ RENEWAL)
Date:*

MonthDayYear
Date
Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number:*
Please enter a valid phone number.
Email:*
example@example.com
Membership Type:*

NewRenewal
Membership Categories

Please select one of the categories below
Regular:*

Adult - $30.00Student - $15.00Corporate Annual - $5000
Lifetime Membership:

Junior Life (Ages 0 - 13) - $100.00Bronze Life (Ages 14 - 20) - $400.00Silver Life - $750.00 (1st)Gold Life - $1500.00 (2nd)Diamond Life - $2500.00 (3rd)
Please make check and money orders payable to ST. PETERSBURG BRANCH NAACP (5130). Mail to: St. Petersburg Branch NAACP *Membership* P.O. Box 35123 St. Petersburg, FL 33705 or Cash App: $NAACP5130

** If paying by Cash App please still complete this application and put your full name on the cash app transaction**
How will you make your payment?*

CheckMoney OrderCash App $NAACP5130
VOLUNTEER OPPORTUNITIES
I am interested in volunteering for the following committee (s):*

ECONOMIC DEVELOPMENTEDUCATIONLEGAL REDRESSMEMBERSHIPHOUSINGRELIGIOUS AFFAIRSPOLITICAL ACTIONHEALTHYOUTH WORKSENVIRONMENTAL CLIMATE JUSTICE (ECJ)COMMUNICATIONSARMED FORCES & VETERANSACTSOCOMMUNITY OUTREACHOther
For more information, please contact the local NAACP office at

(727) 657-9975.

If you wish to speak directly to President Esther Matthews please contact her at (727) 900-1170.
Should be Empty:

ST. PETERSBURG BRANCH NAACP (5130)

MEMBERSHIP IS POWER!

MEMBERSHIP APPLICATION

Membership Categories

VOLUNTEER OPPORTUNITIES