Membership Application

My check for $ _______________ is enclosed made out to NAPS^*.

Northumberland Association for Progressive Stewardship, P. O. Box 567, Heathsville VA 22473

Check membership category desired*

_____ $1.00 Student

_____ $15 Individual

_____ $25 Family

_____ $50 (or more) Business or Corporate

_____ $100 Sustaining

_____ $250 Patron

Name(s) ___________________________________________________

Address ___________________________________________________

Phone ___________________ Email _________________________

Please check activities you would like to participate in:

____ Adopt-a Highway ____ Finance

____ Environmental Education ____ Membership

____ Fund Raising ____ Monitoring County Boards

____ Exhibits ____ Special Events Coordination

____ Publicity and Newsletter ____ Any Project Assignment

____ Annual meeting ____ Scenic Improvement

____ Education ____ Community Issues

____ Other (please specify):

^* The Internal Revenue Service has determined that NAPS qualifies as a tax-exempt organization under section 501 (c) (3) of the Code. As such, dues and contributions to NAPS may be deductible by the donor for tax purposes.