NPHC of Chicago Chapter Dues Form v2

NPHC of Chicago Chapter Dues Form

This form is to be used to provide information to the Financial Secretary that chapter dues have been sent to the Treasurer via Zelle or CashApp.
The amount of NPHCC Chapter Dues if $100. There is no late fee assessed at this time.

Zelle Payments

Send to treasurer@nphcchicago.org ; include your chapter name and three letter organization name on the "Memo" line.

CashApp Payments

Send to treasurer@nphcchicago.org ; iinclude your chapter name and three letter organization name on the "For" line.

If you have any questions, please reach out to financialsec@nphcchicago.org.

Please note: If you want to submit a check, please mail the check to the address below and include your chapter name on the memo line of the check along with the form that can be found on the Council Resources via https://www.nphcchicago.org/council-resources

NPHC Chicago

P.O. Box 438966

Chicago, IL 60643
Full Name of Person Submitting Form*

First NameLast Name
Email of Person Submitting the Form*
example@example.com
Telephone Number of Person Submitting Form*
Please enter a valid phone number.
Name of Organization*
Chapter Name *
Treasurer Name *

First NameLast Name
Mode of Payment*
Date of Payment*

MonthDayYear
Which are you paying?*

Chapter Dues ($150)National Fee ($50)
Amount of Payment *
Should be Empty: