Application for General Membership

Application for General Membership
Please enter the following information as you would like it to appear on your membership record. If you don't know your chapter's number, please contact your local chapter leader or Royal Neighbors Philanthropy team at (309) 732-8216.
Check one:*

AdultYouth (Ages 0-15)
Name of applicant*

First NameMiddle InitialLast NameSuffix
Chapter #*
Chapter city (if known)
(State)*
Applicant's complete address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth*

MonthDayYear
Date
Sex*

MaleFemale
Phone with area code
Email*
example@example.com
Parent / guardian name if youth applicant

First NameMiddle InitialLast Name
How did you learn about us?

Local chapterAgentFamily member/friendCorporate websiteAdvertisementOther
As a member, I agree to uphold the principles of Faith, Unselfishness, Courage, Endurance, and Humility on which Royal Neighbors of America was founded more than 130 years ago.

I understand that this complimentary membership is good for one year after the date of issue. If you are a member of a college chapter, your complimentary membership is good for four years after the date of issue. If this is a youth membership, the membership is valid until the age 15.5. After this time, the youth member will need to join as an adult member.

If you wish to remain a member of Royal Neighbors of America after this time, there will be a $20 annual fee to maintain membership. If you purchase a Royal Neighbors product, you are a member throughout the life of this product, and there is no additional annual fee for membership.
Signature of adult applicant

Clear
I am applying for youth general membership on behalf of the youth applicant.
Signature of parent / guardian

Clear
Should be Empty: