Date: _________________________                  Member Name: _________________________

Mailing Address: _______________________________________________________________________

Daytime Phone: _________________________  Evening Phone: _________________________

E-mail Address: _________________________  Is this a renewal? Yes No

How would you like your newsletter delivered?  Snail Mail ___ Email ___                                                                                   Will find on Website ___                                                                                                                Will find on Yahoo! Groups ___

[__] I would like to donate $15/year to become a member of the NNFN.

[__] I would like to donate $250/ one time to become a lifetime member of the NNFN.

[__] Our family (four members or less) would like to donate $20/year to become members of the NNFN.*

[__] Our family (four members or less) would like to donate $350/ once to become lifetime members of the NNFN.*

*Please list the members of your family in the boxes below if you select this option:

1. _________________ 2.__________________ 3.__________________ 4.___________________

$______ Donations greater than $15 are welcome and greatly appreciated.

Please mail to: NNFN Membership Chairperson
P.O. Box 71481
Reno, NV 89570