NCCS Membership Form

2008
(January 1-December 31, 2008)

Acct: 62006-4810

Membership Information (please print clearly): $35.00 Dues $350 Lifetime

Name:________________________________________________________________

Address:_______________________________________________________________

City__________________________________State_____________Zip_____________

Telephone: Home ( )________________ Office ( ) ___________________

EMAIL___________________________(Arch)Diocese:_________________________

My Current Council Scouting Position:_____________________________________

With the ___________________________________________________ Council, BSA.

My Current Position in Catholic Scouting is (please check all which apply):

Member of the NCCS Executive Board

Member renewal

Appointed Chairman or Chaplain of a Diocesan Catholic Committee on Scouting

I am a Lifetime Member – just updating information and confirming BSA registration

NEW MEMBER

I choose now to become a Lifetime Member, and submit a one-time dues payment.

PLEASE SEE OPPOSITE SIDE FOR UPDATE AND PAYMENT INFORMATION
UPDATED INFORMATION ONLY
2008

Membership Information (please print clearly): $35.00 Dues $350 Lifetime

Name__________________________________________________________________

ALL PREVIOUS INFORMATION THE SAME

INFORMATION HAS CHANGED SINCE LAST UPDATE, PLEASE SEE OPPOSITE SIDE FOR ADDRESS CHANGE

YOU MUST FILL IN BSA SCOUTING INFORMATION ON OPPOSITE SIDE OR REGISTRATION WILL BE DELAYED

My Current Position in Catholic Scouting is (please check all which apply):

Member of the NCCS Executive Board

Member renewal

Appointed Chairman or Chaplain of a Diocesan Catholic Committee on Scouting

I am a Lifetime Member

I choose now to become a Lifetime Member, and submit a one-time dues payment of $350.

Payment Information:

Please mail this form and your check of $35.00 yearly dues or $350.00 lifetime or

Credit Card Number________________________________Exp. Date____________

Amount $__________________ Acct: 62006-4810

To: NCCS Secretary
BSA Relationships Division
1325 West Walnut Hill Lane
P.O. Box 152079
Irving, TX 75015-2079

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October 12 2007