Membership Pre-Membership Application -------------------------------------------------------------------------------- NABC Address: 1111 Main Street, Suite 1000 Kansas City, Missouri 64105-2136 Tel: 816-878-6222 (NABC) Fax: 816-878-6223 -------------------------------------------------------------------------------- Name: _________________________________________ Date of Birth:____________________________________ School/Institution Name:____________________________________ Previous member of the NABC? Yes________ No______ If Yes, when/where? _________________ / ____________________ Coaching Position: (Please check) Head Coach: __ NCAA: Division: ________ __ NAIA: Division: _______ __ Women's (at any level) __ Community or Junior College __ High School __ Youth Program Assistant Coach: __ NCAA (please circle exact position): DI Full-time?.......Admin Asst.?......Part-time Asst.?......Grad. Asst.?.....Other? DII Full-time?.......Grad. Asst.?.......Part-time?........Other? DIII Full-time?.......Grad. Asst.?.......Part-time?........Other? __ NAIA (please circle exact position): Full-time?......Part-time?......Grad. Asst.? __ Women's (at any level) __ Community or Junior College __ High School Other (please explain): _____________________________________________ Home Address: __________________________________________________ Institution Address: ________________________________________________ Home Phone: ___________________________Cell Phone: _______________ School/Office Phone: _____________________ Return Fax: _______________ Email Address: ____________________________ Send mail to: Home Address__________ School Address__________ The deadline for submitting applications is September 1, 2009. However, from September 2, 2009 through November 1, 2009, we will process late applications and there will be an additional $50 fee added to the membership dues. Membership applications that are received after November 1, 2009 will be held for processing until after our annual convention. We will begin processing those applications after April 15, 2010. Submit your application for the 2009-10 Membership Year by fax to the NABC office at (816) 878-6223 or (816) 595-6154. If you are presently coaching, we also need a letter of verification of your coaching position on the letterhead of your school or organization. It must be signed by your Athletic Director or Principal and must state the title of your position and whether your position is full-time or part-time. Please be sure to complete all requested information. Call the NABC Membership Services at (816) 878-6222 if you have any questions. THANK YOU FOR YOUR INTEREST!