NSAL-DC Membership Application

Membership Application
Date*

MonthDayYear
Date
Name*

First NameLast Name
Name of Spouse/Partner

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number
Mobile Number
Work Number
E-mail*
example@example.com
Preferred Method(s) of Contact*

HomeMobileWorkEmail
Areas of Interest
Which area(s) are you interested in?*

ArtDanceDramaLiteratureMusicMusical Theater
Please give a brief description of your background and experience in the creative and performing arts (audience member, member of another volunteer arts organization, education, professional training, employment, other).*
Chapter Involvement
Are you willing to serve on a chapter committee or project team?*

YesNo
If so, please indicate your area(s) of interest/special skills:

Competitions & AwardsPrograms & MeetingsCommunicationsMarketingFinanceMembershipOther
New Member Classification & Payment
(July 1 through June 30*)
prevnext( X )
Active Member($140 chapter dues)
$140.00



Dual Spouses/Partners
$200.00



Associate Member ($250 for financial support without active engagement)
$250.00



Affiliate Member ($50 dues for members of more than one chapter)
$50.00



Life Member
$1,500.00



Diplomatic (no cost while in official residence)
$ Free



Chapter Award Winners (Two year complementary membership with annual dues thereafter)
$ Free



Student (Complementary membership for students’ ages 14-22 years in arts programs)
$ Free



Total

$0.00
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