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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) _____ $15.00 / YEAR THRU 12/31

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

LIFE MEMBERSHIP _____ $150.00 ( EARLY ADMITTANCE DURING SET UP, ALL NCCA SHOWS

PLEASE PRINT CLEARLY

NAME: ______________________________________________________________________

ADDRESS: ___________________________________________________________________

CITY/STATE/ ZIP CODE: _____________________________________________________________

TELEPHONE _____________________ EMAIL _________________________________

MAKE CHECKS PAYABLE TO NCCA 43 TIFFT ROAD, NORTH SMITHFIELD, RI 02896-8009

PHONE 401-769-6902 E-MAIL suzukisamm@cox.net

www.ncca.info