NCTE Tax-Exempt Group Fees

BY JANUARY 30, PLEASE SUBMIT THIS FORM PLUS NCTE TAX-EXEMPT GROUP FEES TO: Division Director of Communications and Affiliate Services, NCTE, 1111 W. Kenyon Road, Urbana, Illinois 61801-1096; fax: 217-278-3760; e-mail: .

NOTE: NCTE TAX-EXEMPT GROUP FEES MUST BE PAID BEFORE YOUR REPORT IS CONSIDERED COMPLETE.

Full Name of Affiliate/Assembly/TYCA Regional/TAWL Group:

_______________________________________________

 
Amount of Dues: (Make check payable to NCTE)

________$10 Annual Group Exemption Fee OR
________$30 First Time Application Fee

SUBMITTED BY:

Name:
Position:
Date:

FOR OFFICE USE ONLY

Check Number:    _______

NCTE Account Number:    _________________________