APPLICATION FOR MEMBERSHIP

NATIONAL EPISCOPAL SCOUTERS ASSOCIATION

http://www.nationalepiscopalscouting.com

(please print legibly)

NAME: ________________________________________________________________

ADDRESS: _____________________________________________________________

CITY/ST/ZIP: ___________________________________________________________

PHONE #: _______________________________________ DATE: ________________

EMAIL: ________________________________________________________________

Email is the preferred method of communication with members; please ensure

Your email address is legible and correct

YOUTH ORGANIZATION (BSA, GSUSA, Campfire, etc.): ______________________

COUNCIL or REGION: ___________________________________________________

FAITH AFFILIATION (ECUSA, REC, AMiA, etc.): ____________________________

PARISH: _______________________________________________________________

DIOCESE: ______________________________________________________________

Membership contributions are $25 per year for persons over 18, or a one-time $500

Contribution (or $125 per year for five years) qualifies for a Lifetime Membership. The

National Episcopal Scouters Association is a 501(c)(3) non-profit corporation. Your

Contributions are tax deductible.

Mail contributions and this completed form to:

National Episcopal Scouters Association, Inc.

Mr. Amo Kearns

P. O. Box 6574

High Point, NC 27262

336-869-6890 or soxit@aol.com

Please call 210-218-7662 if you have any questions or email fgoodwin@sbcglobal.net

Or

Lyn Reavis

P. O. Box 294

Round Top, Texas 78954