CA HI NAACP Youth Membership Registration

Select Your Unit Below *

Please enter information on this form to make your payment for Youth Membership.

Annual renewal is required unless Bronze Life Membership is selected.

Member Type (Please Select One) *

Regular Youth - $15

Youth (Without Crisis Magazine) - $10

Junior Life Subscription (Age 13 & under; 4 annual payments of $25 each)

Junior Life Subscription (One time payment) $100

Bronze Life Subscription (Age 14-20; 8 annual payments of $50 each)

Bronze Life Subscription (One time payment) $400

First Name *

Last Name *

Street Address *

Address Line 2

City *

Zip Code *

Phone Number *

Email Address *

Enter Comments Here