New Member Application - National Association of Regional ......National Association of Regional...

National Association of Regional Councils 660 North Capitol Street NW, Suite 440

Washington, DC 20001 202.986.1032

www.NARC.org

New Member Application

Organization Contacts

Organization: Date:

Executive Director:

Phone: Email

Deputy Director:

Phone: Email

Transportation Director:

Phone: Email

Organization Address: Street Address City State ZIP Code

Organization Activities Regional Population: Operating Budget: Communities Served: My organization serves as:

Metropolitan Planning Organization Area Agency on Aging

Economic Development District Bi or Multi-State Organization

Additional Programs or Services Offered:

National Association of Regional Councils 660 North Capitol Street NW, Suite

440 Washington, DC 20001 202.986.1032

www.NARC.org

Organization Activities

Our regional priorities include:

Please indicate your policy committee interest areas:

Environment Transportation

Economic and Community

Development

Public Safety

Dues

Dues are calculated by regional population according to the following formula: (Regional population * .005 = dues; maximum $25,000, minimum $1,000)

Enter Regional population: Multiplier: .005

Total Annual Dues:

I would like NARC to invoice me for the amount above:

Additional Notes

Submitting Your Application

202-618-6363

Please sign and return this form to:

Eli Spang Communications & Membership Associate eli.spang@narc.org

Signature Date