NAHAD Dues Renewal 2014

Company Information
Please provide the following information:
Name:
Company Name:
(as it appears on Invoice)
Work Phone:
Email:
Select your current NAHAD Membership Category:
Distributor Membership:
Manufacturer Membership:
Associate Membership:
Affiliate Membership:

Dues Renewal
Membership Type annual renewal fee:

BRANCH annual renewal fee ($125.00 per branch) for additional locations only. If you only have one company location a branch is not owed:
Number of Branches:
Branch Name 1:
Branch Name 2:
Branch Name 3:
Branch Name 4:
Branch Name 5:
IRS Required Notice:
Contributions or gifts to the association are not deductible as charitable
contributions for Federal income tax purposes.
However, dues payments may be deductible as ordinary and necessary business expenses.
NAHAD is a not-for-profit organization, Federal I.D. #23-2324931, incorporated in the
state of Pennsylvania. As such, you are not required to submit form 1099 to us
or the IRS for amounts paid to NAHAD annually in excess of $600.00.
   - denotes required fields