Please list names (first and last names) exactly as they are to appear on membership certificates. Incomplete forms will be returned. Forms will not be processed until membership fees are received.
Mail payment (Cashiers Check or Money Order) to:
C/O Ja'net Miles
P.O. Box 442638
Lawrence, KS 66044
Please include in the memo line or your payment "NBLSA PLD" and include a copy of your membership roster with your payment.
If interested in paying by credit card, please email firstname.lastname@example.org.
Please indicate the total amount you will be submitting for your chapter. Chapter Charter Dues are $100.00. Any members that join under the Charter Membership, the General Membership fee will be waived.