NAWDP Membership Application Form

Name: _____________________________________________________

Title: ______________________________________________________

Organization: _______________________________________________

Address: ___________________________________________________

City/State/Zip: _______________________________________________

Phone: _____________________________________________________

Fax: _______________________________________________________

Email: _____________________________________________________

Recruited By: _________________________________________________

                        I agree to abide by the NAWDP Code of Ethics.

                                 Signed: ___________________________________________

Please check ONE category which best represents the place you work:

  Community Based Organizations   Federal, State, and Local Agencies   Self-Employed Consultant/Trainer
  Correctional Facilities   Public & Private Education Institutions   Welfare Agencies
  Economic Development Agencies   One Stop Career Centers   Workforce Investment Boards
  Faith Based Organizations   Research Organizations    

Yes! I want to join the National Association of Workforce Development Professionals!

Annual Member ($50) _______

Lifetime Member ($750) _______

Payment Information:

___Check (make payable to "NAWDP"; FEIN: #52-1739506) ______

___Charge to: Visa ______ MasterCard ______ AmEx _______

Name of Account: ________________________________________

Account #: ______________________________________________

Exp. Date: ______________________________________________

Signature: ______________________________________________

Return form to:

NAWDP, Attn: Membership Dept:
810 First Street, NE, Suite 525, Washington, DC 20002-4227
Fax: (202) 589-1799

NAWDP due payments are not tax-deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense. NAWDP memberships are non-transferable and non-refundable.