Membership Application
NAACP Branch 7132 Harrisonburg-Rockingham
Become a member today and impact your community forever!
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Are you a registered voter?
yes
no
Annual Membership
Adults (ages 21 and older)………………………………$30
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