National Governmental Collectors Association

MEMBERSHIP INFO

NATIONAL
GOVERNMENTAL
COLLECTORS
ASSOCIATION

848 N. Rainbow Blvd. #559
Las Vegas, Nevada 89107

832-602-8017

Membership Application Form

Eligibility: Any person(s) employed by and / or responsible for the collection of revenue due a governmental entity. Membership dues are:

Type of membership application:
Name:
Title:
Name of Employer/Department:
Business Address 1:
Business Address 2:
City:
State:
Zip:
Business Phone:
Fax:
E-Mail Address:
Promotional Code (if applicable):
I do hereby make application for membership in the National Governmental Collectors Association.