PO Membership

Club Name (required)

Address (required)

Phone (required)

City (required)

State/Province: Select OneWashingtonAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWest VirginiaWisconsinWyomingPuerto RicoCanadaAlbertaBritish ColumbiaManitobaNew BrunswickNew FoundlandN.W. TerritoriesNova ScotiaOntarioPrince EdwardQuebecSaskatchewanYukon

Zip Code: (required)

Booster Club Administrator Information

First Name: (required)

Last Name: (required)

Position Select OnePresidentVice PresidentTreasurerSecretaryPresident ElectMembershipFundraisingConcessionClothingVolunteer CoordinatorNewsletterPublic RelationsSpecial EventsSpecial NeedsVolunteerOther

Email (required)

Telephone (required)

School Affiliation (select one)

Does your Booster Club/Group support a School or Non-School based program? SchoolPublic Elementary SchoolPublic Middle SchoolPublic High SchoolPrivate Elementary SchoolPrivate Middle SchoolPrivate High SchoolCollege/UniversityNon School

School Contact Information (if applicable)

School Name

School City

School Official who oversees your Booster Club

First Name

Last Name

Position Select OnePrincipalDeanVice PrincipalAthletic DirectorActivities DirectorOther

Booster Club Type (list all applicable) What extracurricular activities/programs does your Booster Club support: (i.e. band, football, soccer, 4H)

Booster Club Status (select one) Please select the option below that best identifies the current status of your booster club. UnknownPre Start-up (have not established our booster club yet)Start-up (initial phases of getting started)Early Stage (officers elected, by-laws in place, basic meetings)Organized and Growing (committee members, fundraising, conducting events)Well Established (501(c)(3) registered, board of directors, annual planning, committees)

Club Needs As a member of the NBCTC your group will be supported by an experienced advisor. Let us know if your group has any immediate needs, concerns or questions:

If you have spoken to one of the NBCTC representatives, please take a moment to indicate which representative. Taking the time to do so will make it easier for us to provide you with the proper assistance in the future.

Were you referred by a NBCTC representative? YesNo

NBCTC Representative Name:

P.O. #