NCNW CHICAGO CENTRAL SECTION 2025-2026 MEMBERSHIP APPLICATION

2025-2026 MEMBERSHIP APPLICATION

The mission of the National Council of Negro Women is to lead, advocate for, and empower women of African descent, their families, and communities
Date*

MonthDayYear
Date
Title:

Ms.Miss.Mrs.Dr.Rev.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Birthday (MM/DD)*
Please List Affiliate Organizations you are a member of: (Include Chapter/Section/Region, if applicable)
Age*

11 - 17 years old (YOUTH)18 - 22 years old (COLLEGIATE)23 - 35 years old (YOUNG ADULT)35+ years old (ADULT)
Membership Status*

NewRenewal/Reactivation
How did you hear about our section?
Annual Memberships & Dues

$20 Youth ($10 National + $10 Local)$40 Collegiate ($25 National + $15 Local)$175 Young Adult & Adult ($75 National + $100 Local + Annual Assessment)
LIFE MEMBERSHIPS & DUES

$1100 Life Member ($1000 National one-time payment) + ($100 Local + Assessment due annually)$1600 Legacy Life Member ($1500 National one-time payment) + ($100 Local + Assessment due annually)
MEMBERSHIP DUES INFORMATION
1. $1000 Life Membership Dues can be paid in a one-time payment OR two (2) bi-annual installments OR four (4) installments of $250 in 12 months directly to the NCNW national office.
2. The $1600 Legacy Life Membership Dues can be paid in a one-time payment OR two (2) bi-annual installments OR four (4) installments of $375 in 12 months directly to the NCNW national office.
3. Chicago Central Section members are responsible for $100 Local Dues + an Annual Assessment.
I am interested in serving on the following committee(s)*

CaresCommunity Service & OutreachEconomic Empowerment & EntrepreneurshipFundraisingHealth & WellnessMembershipPolicies & ProceduresScholarshipSocial JusticeSocial & HospitalityTechnologyYouth & Young Adult
Mail all checks or money orders payable to:

NCNW Chicago Central Section

P.O. Box 438614

Chicago, IL 60643

OR

ZELLE: treasurer@chgocentralncnw.org

Memo: New Member Membership
Should be Empty: