Branch Assessment Form
Please complete the form below. The NANM fiscal year is September 1 - August 31. Note that payment of assessments are due from all active branches by December 31st each year. You can direct all inquiries about your branch assessment to our National Executive Secretary, Ms. Dorothy Canady (nanmexecsec@comcast.net).
Name of Branch
Region
Central Region: residents of IL, IN, IA, MI, MO, NE, ND, OH, SD, and WI
Eastern Region: residents of CT, DE, ME, MD, MA, NH, NJ, NY, PA, RI, VT, VA, and DC
Southeastern Region: residents of AL, FL, GA, KY, NC, SC, TN, WV
Southwestern Region: residents of AR, CO, KS, LA, OK, MS, NM, TX
Western Region: residents of AK, AZ, CA, HI, ID, MT, NV, OR, UT, WA, WY
Branch Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Does your branch have 501c3 status?
Yes
No
If your branch has 501c3 status, have you filed federal taxes for the past 3 years?
Yes
No
Current Officers
Name
Term of Office
President
Vice President
Secretary
Asst. Secretary
Treasurer
Financial Secretary
Parliamentarian
Chaplain
Use the excel worksheet found on the NANM website to upload the current information about the members of your branch. You may attach and upload the completed document here.
Browse Files
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Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Expiration Year
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