National Socialist Movement

LIFETIME MEMBERSHIP APPLICATION

 

Name _______________________________________________________________________

 

Address _____________________________________________________________________

 

City _________________________________ State ________    Zip Code _________________

 

Country (if other than U.S.) ______________________________________________________

 

Telephone Number (_______) ____________ - ___________

 

E-Mail Address _______________________________________________________________

 

Are you now or have you ever been a member of the NSM?      o Yes     o No    

 

 

MEMBERSHIP LEVEL SELECTION

 

o LIFETIME Member (USA) $600.00             

o LIFETIME Member (INTERNATIONAL) $800.00    

 

 

LIFETIME MEMBERSHIP GUIDELINES

 

  1. Lifetime Memberships are nonrefundable.
  2. Lifetime Memberships are non-transferable. However, if the member passes away prior to having the Lifetime Membership for at least 20 years, the Lifetime membership can be transferred to a *family member for the remaining time up to 20 years total.
  3. Lifetime Memberships carry all benefits, discounts and privileges of a Party membership in effect at the time of joining, or in the future if new Party benefits are added.
  4. Lifetime membership cannot be downgraded for regular Party memberships.

 

*Family member is immediate family; wife, son, or daughter.

 

PAYMENT INFORMATION

 

To Submit Form: Complete and return with payment. Check or Money Order must be made payable in US dollars drawn on a US Bank. Make check or money order payable to NATIONAL SOCIALIST MOVEMENT. Returned checks will be electronically re-deposited along with a return fee of $30.00, plus an additional $16 fee to cover NSF check charges to NSM. (or as allowed by state law).

 

To pay by credit card complete below:

 

Credit Card:  o Visa    o Master card    o Discover    

 

Card # __________________________________________________________________________

 

Expiration Date _____________ /______________   

 

CVC Code ___________ (this is the extra 3 digit security number on the back of your card on the signature line)

 

Signature ________________________________________________________

 

I authorize the NSM to complete two payments of $300.00 on the below listed dates to complete my Lifetime Membership request.

 

Date: Day/Month/Year__________________________Day/Month/Year____________________ 

 

Send completed membership form, check or money order / credit card payment to:

 

Lifetime Membership

National Socialist Movement

P.O.Box 13768

Detroit, MI. 48213 

 

By completing this Lifetime membership application, I certify that I am seeking to become an active (paid) Lifetime Member of NSM and that I agree to abide by the principles of the National Socialist Movement. I understand the membership is based on the criteria in effect for Lifetime memberships as detailed on this application.

 

________________________________________________________         

                                 Signature

 

            __________________________________

                                          Date