NBICF Membership Form

First Name: Last Name:

First Name: Last Name:

Street: (mailing address)

City: Zip: Email:

Day Phone: Evening Phone:

My Ancestry:

My Italian Interests:

I would like to volunteer. Check all items that interest
you or indicate other ways that you would like to help.

Festa Italiana Cooking or serving at dinners Working in office or library Music Groups Fundraising & Events Other

Check One
New Member Renewal

Membership Type:
Individual - $25 Family - $30 Patron - $50 Donor - $100 Life - $500

Donations to the Building, Scholarship, Cultural Center or other Funds are gratefully accepted.
Fund/Purpose   Amount:  

NBICF is a registered non-profit California corporation.
Donations and dues are tax deductible to the extent of the law.

Make check payable to "NBICF" and mail to:

NBICF
64 Brookwood Avenue
Santa Rosa, CA 95404