By special request, we have arranged the opportunity for you to order a plaque signifying your NACAŽ membership. Each plaque will be personalized with the member's name and the year their membership began. These plaques are available for a limited time only for $70.00, shipping included. To order, complete ALL information below and return this form (with your check made payable to NACAŽ) to Lori Ringo.

Member Name to appear on plaque:

Name and Address plaque is to be shipped to:

Current phone number: