NCPS Membership Application

NOTE: This form is not intended to be completed online. Please print it and fill it out, then mail it to the address listed below along with your dues check.

Click HERE for a printable form

NCPS Membership Application

Please type or print clearly: Date _______________________________

Name_______________________________________ Phone ( )____________

Address_____________________________________________________________

City___________________________ State______________ Zip______________

Email Address ________________________________________________________

Membership Type (check one):
Regular (Annual Dues $25) ______ Student (Annual Dues $10) ______ Lifetime ($400) ______

Please include a check for the appropriate membership, made out to NCPS, along with this application and a biographical sketch of about 35 words for our newsletter.

Are you a new member? (please circle): YES or NO
Each new member may choose to receive a critique of three poems. If you wish the critique, please send three copies of each poem and two SASEs along with this application.

MAIL TO:
Guy & Carolyn York
315 N. Steele St.
Sanford, NC 27330

YOU CAN HELP!
Please let us know if you would like to serve on a committee by specifying one of the following: Workshops
Book Sales Membership Other: _____________