2020 Membership Information Form

Please provide us with all of the following information:

Note: If you have questions about this process, contact: the Membership Chair- Wayne Marshall 303-525-9191 or waynefmarshall@gmail.com

-Chick one of the following: --- Renewal Membership --- New Membership

-Name:
-Phone Number:
-Email Address:
-Mailing Address: Street, City, State, Zip Code

USING A CHECK TO PAY YOUR DUES:
#1 Make it out for: $5.00
Make it to: NFB Seniors Division
Make the Memo: Either –Renew Membership – or – New Membership

#2 Send your check, along with your filled out membership form to our Treasurer; if you emailed your information form, you do not need to send it again, with the check:

Duncan Larsen
Colorado Center for the Blind
2233 West Shepperd Ave.
Littleton, CO 80120

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