Membership Form

MEMBERSHIP APPLICATION FORM

Use this form to join NTA today.
(Includes subscription to the National Tax Journal and the Proceedings of the Annual Conference in Taxation.)

BY MAIL
National Tax Association
725 15th Street NW #600
Washington DC 20005-2109
By FAX
to Charmaine J. Wright
202-737-7308

1. Please mark your category

Mark Here	Category	Amount
	Sustaining	$500 or more
	Corporation¹	$ 350
	Government Agency ²	$ 370
	Corporate/Individual/Professional	$ 140
	Government/Academic Individual	$ 100
	Full-time Student	$ 40
	Retiree	$ 45

¹Corporation includes 3 Memberships
² Government Agency includes 5 Memberships
Please type member names for corporation and government agency membership options here:

2. Please provide the following member information:

Name
Title
Organization
Street address

City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail

3. Areas of Interest, Comments

4. Please choose payment type

Mark Here	Category
	Check Payable to National Tax Association
	Voucher
	Purchase Order
	Bill (For Corporate and Government Agencies only)
	VISA/Master Card (Credit Card Form):
	PayPal