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Student Membership Application
(Print Out Form)
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Information (Please print clearly)
IMPORTANT- Where do you prefer mail to be sent? r Home r School rMr. rMrs. r Ms. r Male r Female Date of Birth _______________ Name_________________________________________ Credentials___________________________________ Address_____________________________________ ____________________________________________ ____________________________________________ City__________________ State___________________ Zip____________________ Country________________ Home Phone __________________________________ Fax__________________________________________ E-mail Address_________________________________ SCHOOL Address _____________________________________ ____________________________________________ ____________________________________________ City __________________ State __________________ Zip___________________ Country________________ School Phone __________________________________ School Fax ____________________________________ Email Address _________________________________ Your dues are shared by NASW and your state chapter. You will be assigned a chapter based on your preferred mailing address. Students do have the choice of affiliating with the chapter in their home state or the chapter in the state in which they currently reside, or in the chapter where their school is located. If you wish to affiliate with a particular chapter for one of these reasons, please indicate it here. Chapter Preference ______________________________
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EDUCATION (List highest social work degree.) Applicants must complete information below! Anticipated Degree: r BSW r MSW Date Entered Program (Mo/Yr)____________ Graduation (Mo/Yr) ___________________ College or University/Division____________ ___________________________________ City
& State _________________________ DEMOGRAPHICS Ethnic/Racial Origin (check one only) r
African American/Black r American Indian or Alaskan Native r Asian American or Pacific Islander rChicano/Mexican American r Puerto Rican r Other Hispanic/Latino r White/Caucasian (not Hispanic/Latino in origin ) r Other (specify)_____________________ Student members: a copy of your current identification card must be attached to this application NOTICE TO MEMBERS Important information concerning dues deductibility for income tax purposes. Payments, contributions, or gifts to the National Association of Social Workers, Inc. General Fund are not tax deductible as charitable contributions for income tax purposes. However, they may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of association lobbying activities. The National Association of Social Workers, Inc. estimates that the nondeductible portion of your dues allocable to lobbying for calendar year 2001 is 10.32%. NASW estimates the nondeductible portion for calendar year 2002 to be 13.78%. Membership dues include annual subscription fees of $20.00 for Social Work, $12.50 for NASW NEWS, $2.00 for NASW newsletters in the following states and divisions: CA, GA, NY, NY City, OK, OR and TX; $1.00 for NASW newsletter in TN. SEND APPLICATION TO INTERNET Download an NASW application online at www.socialworkers.org MAIL Mail application to NASW, P.O. Box 98272, Washington, DC 20077-7343 FAX Fax application to (202) 336-8331
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MEMBERSHIP DUES Membership dues are subject to change. r Student BSW r Student MSW $45/year Open to anyone currently matriculating in a Council on Social Work Education (CSWE) accredited social work degree program, or a pro- gram eligible for candidacy. A copy of your current student identift- cation card must be attached to this application Eligibility for the BSW or MSW Student membership category is limited to four (4) years for each degree over the lifetime of membership, not necessarily continuous. JOIN NASW'S SPECIALTY PRACTICE SECTION Mark section(s) below and add section fee to dues payment. Get connected to colleagues in your specific interest area. Section membership offers special benefits and opportunities, NASW Specialty Practice Section information is available on the NASW Web site at wwwsocialworkers.org. Or call 800-742-4089. Specialty Practice Section (Fee $35 per year for eacb section selected) rAging r Alcohol, Tobacco, andOther Drugs (ATOD) r Poverty and Social Justice (NEW) r Child Welfare (NEW) r Private Practice r Health (NEW) r School Social Work NASW SPECIALITY JOURNAL The NASW Press publishes four speciality journals on a quarterly basis, which are available to students at a discounted rate. Check them out on the nASW Press Web site at www.naswpress.org. To subscribe, check the appropriate box(es) below and add the fee to your total payment due in the "Payment Information box on the next page. Health & Social Work: r 1
year-$30 r
2 years - $52 Children & Schools: A Journal of Social Work Practice: r 1 year - $30 r 2 years - $49 Social Work Abstracts r 1 year- $35 r 2 years - $56 Social Work Research r 1 year - $30 r 2 years - $49 |