(PLEASE PRINT CLEARLY or TYPE)

 

Shrine Name:                                                                                                                                                    

Address:                                                                                                                                                              

City/State/Zip:                                                                                                                                                    

Phone:           (          )                                                            Fax: (          )                                                          

Cell:                (          )                                                            Other: (          )                                                     

E-mail:                                                                                                                                                                 

Web Site Address:                                                                                                                                             

Director’s/Rector’s Name:                                                                                                                                

 

Full membership is $300.00 per year, payable by March 31.

Full Membership qualifies for (1) vote at the National Convention held each year in November and ONLY ONE attendee at the full membership price.

 

(For NASPA office use only)     Date Paid                                Check Number                           

 

 

SHRINE ASSOCIATE MEMBERSHIP

& BUSINESS MEMBERSHIP APPLICATION 2015

(PLEASE PRINT CLEARLY or TYPE)

 

Shrine/Company:                                                                                                                                        

Address:                                                                                                                                                         

City/State/Zip:                                                                                                                                                

Phone:           (       )                                                               Fax: (        )                                                            

Cell:                (          )                                                            Other: (          )                                                     

E-mail:                                                                                                                                                            

Web Site Address:                                                                                                                                        

1.                  Associate’s Name:                                                                                                                             

2.                  Associate’s Name:                                                                                                                                  

3.                  Associate’s Name:                                                                                                                            

 

Each Associate Shrine membership is $ 150.00 per year, payable by March 31.

Associate Membership does not qualify for a vote in the official proceedings of NASPA and must pay the Associate Membership registration fee for the annual convention.

 

Each Business membership is $ 200.00 per year payable by March 31.
 

(For NASPA office use only)     Date Paid                                Check Number                           

 

Make Check Payable to NASPA and mail to:   Reverend Monsignor Vito A. Buonanno

Basilica of the National Shrine of the Immaculate Conception

400 Michigan Avenue, NE

Washington, DC 20017-1566