The National Association of Presbyterian Scouters

Application for Membership
National Association of Presbyterian Scouters

Youth are the future and they are the Church. I pledge my service and support to Youth. As a Presbyterian Scouter or Associate member, I will take action or respond to opportunities for service through the Church and through Scouting. I will be a light for the National Association of Presbyterian Scouters.

(please print clearly)

DATE__________________________

NAME________________________________________________

ADDRESS_____________________________________________

CITY__________________________STATE____ZIP___________

HOME PHONE______________

E-MAIL ADDRESS ______________________________________

COUNCIL NAME AND NUMBER____________________________________

CHURCH______________________________________________

ASSOCIATE MEMBERS CHURCH________________YOUTH AGENCY

AFFILIATION___________________

SIGNATURE____________________________________

CHECK ITEMS THAT APPLY:

/_/New Member
/_/Associate Member
/_/Renewal Member

/_/Lapel Pin ($5.00)

/_/Annual Member ($25.00)
/_/Five-year Membership ($80.00)
/_/Ten-year Membership ($180.00)
/_/Life Membership ($400.00)

Make your check for the total amount due to NAPS and attach it to this form. Form and check should be sent to: Programs for Religious Activities with Youth (P.R.A.Y.), 11123 S. Towne Square, Ste B, St Louis, MO 63123

RECRUITED BY:_________________________________

NAPS Accessories
The lapel pin is a Celtic cross with a fleur-de-lis, showing the tie between the Presbyterian Churches in America and Scouting. The cost is $5 per pin.
The regular membership patch is embroidered on twill. It has the NAPS logo like the lapel pin, but also has the name of the organization. Cost is $2.00 per patch.
To celebrate our 15th Anniversary we had a special patch made. 100% embroidered to match the original membership patch, it also has the words "Fifteenth Anniversary" embroidered in gold across the patch to commemorate the occasion. Cost is $4.00 per patch.

I would like to purchase some of the items available from the National Association of Presbyterian Scouters. I will include this form and my payment for the items listed below. Checks and Money Orders should be made out to "National Association of Presbyterian Scouters":

 Qty.  Item  Price  Ext. Price

 ________
 Lapel Pins  $5.00 each

________

 ________
 Membership Patch  $2.00 each

 ________

 ________
 15th Anniversary Patch  $4.00 each

 ________

Please Print

NAME___________________________________

ADDRESS________________________________

CITY, STATE, ZIP_____________________________________

Phone number with Area Code (just in case):_______________________

NOTE: If you are a collector and would like to be notified by e-mail of any future items as they become available, please check here /_/ and print your e-mail address below:

________@__________________



2013 The National Association of Presbyterian Scouters