National Coalition of Free Men, Greater New York Chapter
www.themalevoice.org
  


MEMBERSHIP FORM


Yes, I would like to join the nation's largest general-issues men's rights organization,  receive a subscription to NCFM-national's bimonthly newsletter Transitions as well as an invitation to participate in NCFM-national's members-only on-line discussion group. Additionally, I would like to be entitled to participate in the Greater New York Chapter's meetings -- held monthly in Manhattan -- and receive ongoing updates of the chapter's activities and accomplishments.

First Name:  ________________________

Last Name:  ________________________

Street Address :  __________________________________________________________

City:  _________________________

State:  ____

Zip:  ________-______

Home Telephone:  ______-______-_______

Work Telephone:  ______-______-_______

Cell Phone:  ______-______-_______

Primary E-mail Address:  __________________________________

Secondary E-mail Address:  __________________________________

Enclosed is my check or money order for:

$50_____for one year's membership for residents of the USA or CANADA
CANADIAN RESIDENTS MUST SEND A U.S. MONEY ORDER
$60_____for one year's membership for residents outside the USA or CANADA, MUST SEND USA CURRENCY
$20_____for one year's membership for residents of the USA or CANADA who are Full-Time Students.  (Attach a photocopy of your current student i.d.)
CANADIAN RESIDENTS MUST SEND A U.S. MONEY ORDER

MEMBERSHIP FEES ARE TAX DEDUCTIBLE.  BACK TO JOIN PAGE.

2003 National Coalition of Free Men, Greater New York Chapter.  All rights reserved.