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Membership Application

Please print this page and send with check to:

NAPS

P. O. Box 567

Heathsville VA 22473

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

Check membership category desired*

	$1 Student		$100 Sustaining
	$15 Individual		$250 Patron
	$25 Family		$50 (or more) Business or Corporate

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		Education
	Annual meeting		Scenic Improvement
	Community Issues		Any Project Assignment
	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.

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