NAAD Membership Form

Name:
Address:
City:
State/Province:
Country:
Postal Code:
E-mail Address:
Diocese:
Order:	Select one Laos Bishop Presbyter Deacon
If Deacon, Ordination Date:
If Deacon or in formation, Birth Date:
Type of Membership	Choose one Regular (New) - $50 Regular (Renewal) - $50 Diaconal Student - $30 Newly Ordained Deacon - $30 Retired Deacon - $30 Life Membership - $1,000 12 Month Extended Life, 1st Year - $400 12 Month Extended, 2nd Year - $300 12 Month Extended, 3rd Year - $300

Please complete and print this form and mail it with your check or money order to: NAAD Membership Office P.O. Box 1324 Paso Robles, CA 93447-1324