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NACIO Membership Form

If you're mailing your Membership application or renewal, print this form and mail it to Tom Goodman, NACo Public Affairs Manager, 25 Massachusetts Ave. N.W., Washington, DC 20001. NACIO Membership is based on a calendar year. Fees for those who join during the year will be prorated quarterly.

If you're submitting this form electronically, click the submit button and call Tom at (202) 393-6226 to make arrangements to pay by credit card or fax a copy of this form to (202) 393-2630.

New Membership Renewal

Last Name First Name MI:

Title:

Address:

City State Zip:

Phone:

Fax:

E-mail:

Check One:

County Staff Member ($75) State Association of Counties ($100) (Add $50 for each additional staff member)

Non-County Government ($175) Business or Corporation ($250)

Amount being mailed (Check or Money Order):