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Wichita Branch NAACP Membership Application  (branch #4043)

Please Print Date_______________

Mr./Mrs./Ms._____________________________________________________________________

Street Address___________________________________________________________________

City_____________________________State________________________Zip________________

Are you a registered voter?___Yes___No

Regular Annual Membership Lifetime Membership

Regular Adult...........$30.00_____              Junior Life-(Date of Birth________________)..$100.00_____

Youth with Crisis.......$15.00_____              Bronze Life-(Date of Birth)______________ )..$400.00_____

Youth without Crisis...$10.00_____              Silver Life................................................$750.00_____

Annual Corporate......$5,000_____              Gold Life..............................................$1,500.00_____

                                                              Diamond Life........................................$2,500.00_____

Please mail this completed form along with your payment to:

The Wichita Branch NAACP

829 N Madison St

Wichita, KS 67202

Thank You for your support

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Membership is the life-blood of the NAACP. We depend on our members’ generosity to insure the NAACP’s independence. We depend on you to keep the flames of freedom burning bright!

IMPORTANT TAX INFORMATION

Gifts and contributions to this NAACP Branch are not deductible as charitable contributions. However, a portion of your dues is passed on to the NAACP National Organization and these payments are tax deductible. The specific amounts that qualify are as follows:

Membership Type Member Rate Tax Deductible Amount

Youth (without Crisis).........................$10    .................................$.5.70

Youth (with Crisis)..............................$15    ................................$ 4.20

Adult.................................................$30    ................................$11.85

Junior Life (ages 13 and under)...........$100   ................................$56.40

Bronze Life (ages 14-21)....................$400    ..............................$236.40

Silver Life..........................................$750    ..............................$414.00

Gold Life..........................................$1500    ..............................$864.00

Diamond Life....................................$2500    ............................$1464.00

Corporate.........................................$5000    ............................$2996.40