HOME JOIN NCFM  

   NCFM Join NCFM Membership Application

NEW MEMBER APPLICATION FORM

  MEMBERSHIPS LENGTH MEMBERSHIP TYPES & BENEFITS AMOUNT
     BENEFACTOR:
$2,500 or more 
Forever BENEFACTOR members receive all benefits listed below and a copy of one or more books.  If you provide an 8x10 signed photography or yourself, it will be framed and displayed in our offices.     
PROTECTOR:
$1,000 to $2,500 
Lifetime PROTECTOR members receive all benefits listed below, continuing recognition on our website and in Transitions, a framed certificate or letter of appreciation, and your name will be engraved and displayed on a plaque.     
GUARDIAN:
$500 to $1,000 
Twelve Years GUARDIAN members receive all benefits listed below, recognition on our website and/or in Transitions, a letter of appreciation, and a framed letter of appreciation.     
GATEKEEPER:
$150 to $500 
Five Years GATEKEEPER members receive all the benefits below, a letter of appreciation, and recognition in one or more issues of Transitions.     
SUSTAINING:
$50 to $150 
One Year SUSTAINING members receive the benefits below and recogniton in one or more issues of Transitions.     
SUPPORTING:
$35 
One Year SUPPORTING members receive "Other Benefits" shown below. $35 
STUDENT:
$10 
One Year STUDENT members can read back issues of Transitions online and access NCFM's Student Yahoo Discussion Group. $10 
"Other Benefits" means: New members should receive a welcome package if we have your correct mailing address.  All members (1) may conditionally join and participate in our general membership online discussion groups (2) should receive email or hardcopiees of Transitions, the Journal of Men's Perspectives (the latter for members without email addresses) (3) may participate in certain NCFM events (4) may attend our Face-to-Face national board meetings, and (5) may join one or more NCFM chapters [additional chapter dues may be required].
PLEASE VERIFY YOUR NATIONAL COALITION FOR MEN CHAPTER (DUES ARE SEPARATE): 
NCFM CHAPTERS:

I do not wish to join a
Chapter at this time.
Arizona$20
Los Angeles$10
Montana$10
NCFM Carolinas$10
New York$20
San Diego$20
Tennessee/Kentucky$20
Twin Cities (MN)$10
Please accept my membership selection(s) above and the following additional donation:  $   
PLEASE VERIFY YOUR PERSONAL CONTACT INFORMATION BELOW:
Please keep my membership confidential.  I understand my name will not be made public regardless of membership level as above.
CONTACT INFORMATION:
(*Required Information)
*First Name:  
*Last Name: 
*Mailing Address: 
 
*City: 
*State:  
*Zip:  
*Country:  
Home Phone:  
Work Phone: 
Mobile Phone: 
FAX Number: 
Occupation: 
*Contact Me By:
Email
Standard Mail*
Do Not Contact
*If you don't provide your current mailing address, we cannon send yhou your welcome package or membership gifts.
PLEASE MAKE ANY COMMENTS, SUGGESTIONS, OR REASONS FOR JOINING, RENEWING, OR DONATING BELOW:
PLEASE ENTER YOUR EMAIL AND A PASSWORD TO CREATE YOUR ONLINE NCFM MEMBERSHIP ACCOUNT**
ACCOUNT INFORMATION:
(*Required Information)

Your Email & Password are used to
login into your online account.

Your password must contain
at least 6 characters.
*Email Address:  
*Re-Enter Email Address:  
*Password:  
*Re-Enter Password:  


           


 
  Copyright 2012 NCFM.  US IRS 501(c)3 non-profit status.