NBICF Membership Form
Fill out the form, print it (use File/Print or Ctrl-P) and mail with check to NBICF

First Name Last Name

First Name Last Name: 

Street (mailing address)

City:   Zip: 


Day Phone:  Evening Phone: 

My Ancestry: 

My Italian Interests:  

I would like to volunteer. Check all items that interest :
Cooking or serving at dinners and events       Computer Skills
Working in office or library    Music Groups      Fundraising
Committee   Other 

Check One: New Member - entitled to one free dinner               Renewal

Membership Type:
Individual  $35  Household  $50  Patron*  $100  Student**  $10  Business  $150

*Patron - entitled to two free dinners                ** Provide a copy of valid student I.D.

Donations to the Building, Scholarship, Cultural Center Funds are gratefully accepted.



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:

                                    64 Brookwood Avenue
                                    Santa Rosa, CA 95404