Northwest Danish Association · 2021-2022 Membership: Individuals and Families

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2021-2022 Membership: Individuals and Families

Become a member of the Northwest Danish Association today. The 2021-2022 membership year is from July 1st 2021 to June 30th 2022.

Check one

New Membership

Renew Membership

Member Contact Information

Name

First Name

Last Name

Spouse/Partner

First Name

Last Name

Check here if you do NOT want to receive e-bulletins with updates on events, programs, and activities

Email Spouse/Partner

Check here if your spouse/partner does NOT want to receive e-bulletins with updates on events, programs, and activities

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Organization/Employer

Annual Memberships

Membership year is July 1 to June 30. Dues renewal date is JULY 1 each year. For a list of membership benefits, visit www.northwestdanish.org/membership

Choose one category

$50 - Adult Individual

$75 - Couple or Family (up to 2 adults and minor children in one household)

$35 - Senior Individual (65+)

$60 - Senior Couple (Both 65+)

$35 - Student Individual (upload a copy of student ID below)

If applying for student membership, please attach a copy of your student I.D. here:

Family Membership: Dependent Children

For family memberships, list names and ages of dependent children (18 & under) if membership privileges desired

Donations

NWDA is a 501(c)(3) non-profit organization, Tax-ID 91-0565541. All donations are tax-deductible. To set up recurring donations, please fill out a separate donation form at www.northwestdanish.org/donate/

Tax-Deductible Donation

$1,000 - Grand Dane

$500 - Great Dane

$250 - Bold Dane

$100 - Noble Dane

$50 - Royal Dane

Employer Matching Funds

If your employer will match your donation to NWDA please enclose your matching gift form.

Other

Volunteer with us!

Would you like to donate your time? We have many volunteer opportunities throughout the year and would love your help! Thank you!

I'm interested in volunteering!

Printed Copies of The Little Mermaid Newsletter	Quantity
$15 - Include printed copies of the quarterly newsletter, The Little Mermaid (covers postage and handling )

Additional Comments

Use this box if you have additional comments regarding the information you have provided above.

Name on payment card:

Please check here to add 3% to the total amount to help us cover the payment processing fees. Thank you!