Please complete each section of this form and send it to NHC by clicking one of the buttons at the bottom of this page. This information also will be used for your entry in our member and sponsor directory.

Primary Contact Person

	First Name *
	Last Name *
	Position
	Phone *
	Email *

Organization / Address

	Organization Name
	Address Line 1 *
	Address Line 2
	City *
	State *		--AL - AlabamaAK - AlaskaAS - American SamoaAZ - ArizonaAR - ArkansasCA - CaliforniaCO - ColoradoCT - ConnecticutDE - DelawareDC - District of ColumbiaFL - FloridaGA - GeorgiaGU - GuamHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaPR - Puerto RicoRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVI - Virgin IslandsVA - VirginiaWA - WashingtonWV - West VirginiaWI - WisconsinWY - WyomingAB - AlbertaBC - British ColumbiaMB - ManitobaNB - New BrunswickNL - Newfoundland and LabradorNT - Northwest TerritoriesNS - Nova ScotiaNU - NunavutON - OntarioPE - Prince Edward IslandQC - QuebecSK - SaskatchewanYT - Yukon
	Zip Code *
	Main Phone
	Main Fax
	Web Site
			How did you find out about NHC?
			Description of Organization/Specialty
			Professional Category (please check all that apply)   Accountant   Advocacy Organizations   Advocacy Organizations - State/Local   Appraiser   Architect   Asset Managers   Association   Attorney/Law Firm   Bank   Builder/Developer   Community Development Corporation   Compliance Services & Software   Consultant   Cooperative Housing   Education and Research Organization/Professional   Elderly Housing   Engineer   Faith-Based Organizations   Financial Services Firm   Foundation   Government (Other)   Government - State/Local   Government Sponsored Enterprise   Housing Finance Agency   Insurance Company   Investment Banker   Labor Union   Lending/Mortgage Banker Institution   Nonprofit Development Assistance Corporation   Owner   Private Mortgage Insurance   Property Management Firm   Public Housing Authority   Real Estate Company/Realtor   Real Estate Investment Trust   Rural Housing   Social Service Organization   Student   Syndicator   Technical Service Provider   Workforce Housing
	Comments

Membership Category (please select one)

Housing Leadership Support Program  (Learn More)
		Chairman's Circle		$ 50,000.00
		Benefactor		$ 30,000.00
		Patron		$ 20,000.00
		Sponsor		$ 10,000.00
Standard Membership
		Pacesetter		$ 5,500.00		(includes 5 employee memberships)
		Sustainer		$ 4,400.00		(includes 4 employee memberships) (Organization with gross revenues between $10 - 19.9 million)
		Supporter		$ 2,750.00		(includes 3 employee memberships) (Organization with gross revenues between $5 - 9.9 million)
		Friend		$ 1,650.00		(includes 2 employee memberships) (Organization with gross revenues between $1 - 4.9 million)
		Subscriber		$ 550.00		(Individual not affiliated with any organization or organization with gross revenues of less than $1 million)
		Retired Individual		$ 100.00
		Student 2 Year		$ 40.00		(proof of full-time enrollment required)
		Student 1 Year		$ 25.00		(proof of full-time enrollment required)

I wish to make an additional contribution of $

Total Amount:  $

     

* Information marked with an asterisk (*) is required.

The National Housing Conference (NHC) is a 501(c)(3) nonprofit organization. Basic membership dues payments to NHC are deductible as charitable contributions for federal tax purposes. A scholarship program also is available. For more information, please call (202) 466-2121 x227.

Membership will not be activated until payment is received.