EmailMe Form - 2020 NC NAACP State Convention Registration

Branch Name *

Branch Unit Number *

Branch President's Name *

Branch President's Email *

Branch Secretary's Name *

Branch Secretary's Email *

Branch Treasurer's Name *

Branch Treasurer's Email *

Branch President's Phone *

### - ### - ####

Branch Secretary's Phone *

### - ### - ####

Branch Mailing Address *

Street Address City State / Province / Region Postal / Zip Code

Branch Phone

### - ### - ####

Branch Assessment

50- 500 Members $250

501- 1000 Members $300

over 1000 Members $550

My branch has already submitted assessments

Payment Method

Check (1 check per branch)

Pay Online with Credit Card or PayPal

Remit payment to: NC NAACP State Conference, PO Box 7186, Greensboro, NC 27417-0186

Attendee Information

Please complete the requested information for each attendee from your branch.

Number of attendees from your unit

Attendee 1 Name

First Last

Attendee 1 Branch Position

Attendee 1 Email

Attendee 1 Phone

### - ### - ####

Attendee 2 Name

First Last

Attendee 2 Branch Position

Attendee 2 Email

Attendee 2 Phone

### - ### - ####

Attendee 3 Name

First Last

Attendee 3 Branch Position

Attendee 3 Email

Attendee 3 Phone

### - ### - ####

Attendee 4 Name

First Last

Attendee 4 Branch Position

Attendee 4 Email

Attendee 4 Phone

### - ### - ####

Attendee 5 Name

First Last

Attendee 5 Branch Position

Attendee 5 Email

Attendee 5 Phone

### - ### - ####

Attendee 6 Name

First Last

Attendee 6 Branch Position

Attendee 6 Email

Attendee 6 Phone

### - ### - ####

Attendee 7 Name

First Last

Attendee 7 Branch Position

Attendee 7 Email

Attendee 7 Phone

### - ### - ####

Attendee 8 Name

First Last

Attendee 8 Email

Attendee 8 Branch Position

Attendee 8 Phone

### - ### - ####

Attendee 9 Name

First Last

Attendee 9 Email

Attendee 9 Phone

### - ### - ####

Attendee 9 Branch Position

Attendee 10 Name

First Last

Attendee 10 Email

Attendee 10 Phone

### - ### - ####

Attendee 10 Branch Position

Attendee 11 Name

First Last

Attendee 11 Email

Attendee 11 Phone

### - ### - ####

Attendee 11 Branch Position

Attendee 12 Name

First Last

Attendee 12 Email

Attendee 12 Phone

### - ### - ####

Attendee 12 Branch Position

Attendee 13 Name

First Last

Attendee 13 Phone

### - ### - ####

Attendee 13 Email

Attendee 13 Branch Position

Attendee 14 Name

First Last

Attendee 14 Email

Attendee 14 Phone

### - ### - ####

Attendee 14 Branch Position

Attendee 15 Name

First Last

Attendee 15 Email

Attendee 15 Phone

### - ### - ####

Attendee 15 Branch Position

Attendee 16 Name

First Last

Attendee 16 Email

Attendee 16 Phone

### - ### - ####

Attendee 16 Branch Position

Attendee 17 Name

First Last

Attendee 17 Email

Attendee 17 Phone

### - ### - ####

Attendee 17 Branch Position

Attendee 18 Name

First Last

Attendee 18 Email

Attendee 18 Phone

### - ### - ####

Attendee 18 Branch Position

Attendee 19 Name

First Last

Attendee 19 Email

Attendee 19 Phone

### - ### - ####

Attendee 19 Branch Position

Attendee 20 Name

First Last

Attendee 20 Email

Attendee 20 Branch Position

Attendee 20 Phone

### - ### - ####

Notes