I, ______________________________________________ am applying for membership in the National
Association of Support Employees and agree to abide by the Constitution and by-laws of the Association.
My check for $52.00 regular member or $20.00 for supportive member is attached. I also agree that I will
join my State Association at this time or when one is established.


Title: ______________________________________________________________________________
Office Address: _____________________________________________________________________
___________________________________________________________________________________
Office Telephone: _________________________ e-mail: ___________________________________
Home Address: _____________________________________________________________________
___________________________________________________________________________________
Home Telephone: ___________________________________________________________________
Home e-mail: _______________________________________________________________________


Are you a new member?  _______________

Are you renewing your membership?  _________________

Sponsor’s Name: ____________________________________________________________________
(Please list the person who contacted you about becoming a member)



Check should be made payable to NASE





                                              Please Mail Completed Form with $52 or $20 to:

                                                            “Open By Addressee Only”
                                                                   Rhonda Hoffman
                                                              107 E Hwy 20, Suite C
                                                                   O’Neill, NE 68763

                                                                   allgolf@kmtel.net
                                                             402-336-3796, ext 118
APPLICATION FOR MEMBERSHIP