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.

Type of Membership

Individual   Organization

Primary Contact Person

	First Name *
	Last Name *
	Position
	Phone *
	Email *

Additional Contacts

	Please enter primary contact person above
	First Name	Last Name	Position	Direct Phone	Email
2
3
4
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6

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
	Type of Organization
	Comments

Membership Category (please select one)

Categories  (Learn More)
		Full Member		$ 2,000.00		(Includes 1 ticket to Gala or Lunch)
		Basic Member		$ 800.00
		Retired Individual		$ 100.00
		Young Leader in Affordable Housing		$ 50.00
Housing Leadership Support Program  (Learn More)
		Chairman's Circle		$ 50,000.00
		Benefactor		$ 25,000.00
		Patron		$ 15,000.00
		Sponsor		$ 10,000.00
		Supporter		$ 5,000.00

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.