NCCA Membership sign up form

For NCCA Membership, please print, fill out and send the following application to the address noted below.

NCCA MEMBERSHIP & DUES

MEMBERSHIP RATES – CHECK THE APPROPRIATE CATEGORY:

ADULT (NEW) _____ ADULT (RENEWAL) _____ $20.00 / YEAR THRU 12/31

JUNIOR (NEW) _____ JUNIOR (RENEWAL) _____ $5.00 / YEAR THRU 12/31 UP TO AGE 16

LIFE MEMBERSHIP _____ $200.00 ( EARLY ADMITTANCE DURING SET UP, ALL NCCA SHOWS

PLEASE PRINT CLEARLY

NAME: ______________________________________________________________________

ADDRESS: ___________________________________________________________________

CITY/STATE/ ZIP CODE: _____________________________________________________________

TELEPHONE _____________________ EMAIL _________________________________

MAKE CHECKS PAYABLE TO NCCA and send to: 43 Tifft Road, North Smithfield RI 02896 -8009

E-MAIL suzukisamm16@yahoo.com

www.ncca.info