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Please accept my application to become a member of the National Water Safety Congress and work with my fellow professionals to save lives and prevent drownings.

 

Type of Membership

 

NWSC Membership Application Date :

-- mm/dd/yy

Name:

Name

Contact Information:

Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Annual Membership Category Please circle appropriate category

Individual . . . . . . . . . .  $    25.00

Water Safety Council . . . . . . . . .  $    25.00

Organization . . . . . . . .$   50.00

Sustaining . . . . . . . . . . . . . . . . . .   $  200.00
Corporate ………....... $ 500.00           

Patron ……………………..........  $1000.00 

 

Make checks payable to the National Water Safety Congress and mail to the following address:

National Water Safety Congress, Inc

P.O.Box 1632

Mentor, Ohio 44061

440-209-9805