Be Involved. Be Connected. Be a Member.

NCPG’s Membership Program Benefits 2014

All members enjoy these great benefits of membership: Powerful networking tools Accurate and timely information, including

quarterly e-newsletter Crucial advocacy efforts with federal

legislators and health agencies--supporting NCPG as the leading national advocate in the fight against problem gambling

Unmatched professional development and education in our field

And the knowledge that NCPG members support essential services for problem gamblers and their families, including the National Helpline: 800-522-4700

Discount on National Conference registration fee and NCGC Exam fee

Individual Members Categories

Individual Plus $100 Includes all the benefits of the Individual membership, with the addition of a subscription to International Gambling Studies, a peer-reviewed interdisciplinary journal in gambling studies.

Individual $75 Includes full voting rights, the NCPG Newsletter, member certificate, bi-monthly subscription to Addiction Professional, discount on literature and discount on conference registration.

Honored Seniors $65 A special "$65 at 65" membership fee for Individual Members at least 65 years of age who are not the designated Representative for an Affiliate or Organization. You'll receive all the benefits of Individual membership with special savings. Please send a fax or PDF of your current driver’s license or other photo identification with birth date.

Student $35 Includes full voting rights, the NCPG Newsletter, a special "student rate" for conference registration, the opportunity to submit Master's theses /Doctoral dissertations for annual awards, and special opportunities to learn from and network with leaders in the field. Please send a fax or PDF of your current transcript or class schedule showing a full-time course load, usually 12 hours per semester or more.

Organizational Member Categories Organization/Corporation Non-profit/Government Agency

Silver Member (New!) $2,500 $1,750

Includes organizational recognition in the NCPG newsletter and annual report and a certificate suitable for display. Designated Organization Representative votes (1 per organization) on company’s behalf; is eligible for Board nomination in the Organization category; receives communications discounts, subscriptions. Up to two (2) additional specified staff/board members receive Individual Memberships. (Benefits are for up to 3 people).

Gold Member $5,000 $3,500Includes the above except benefits are for up to a total of 5 specified staff/board members (4 + Representative).

Platinum Member (New!) $10,000 $7,000Includes the above except benefits are for up to a total of 10 specified staff/board members (9 + Representative).

Be Involved. Be Connected. Be a Member.

NCPG Membership ApplicationYes! I want to support the work of NCPG and its affiliates by renewing my membership or joining as a new member.

New member Renewing member

Individuals Member Categories

Individual Plus $ 100 Honored Seniors $ 65

Individual $ 75 Student $ 35

Organizational Member Categories: Organization/Corporation Non-profit/Govt. Agency (30% discount)

Silver Member $2,500 $1,750

Gold Member $5,000 $3,500

Platinum Member $10,000 $7,000

_________ Your membership fee (mark the box above)

_________ Additional tax-deductible contribution (or round up if you wish; optional)

_________ Total

New or renewing member’s name E-mail Org. Representative

Company (as you wish it to appear in materials) Job Title

Address

City State/Province Zip/Postal Country

Phone: Work Cell Fax Home

Method of payment - please circle one. Please make check payable to NCPG in U.S. funds. VISA MasterCard Amex Check enclosed Money Order Purchase Order # ____________

Card Number Expiration (mm/yy) ________ Security Code _________

Credit Card Billing Address: __ __ ______________________________________________________________________________(Billing address as shown on credit card statement)

Credit Card Billing Zip Code: ______ __

Name as it appears on card (please print) Authorized Signature Date

Office use only: Date rcvd _______________ Initials ________

Date Processed_________________ Initials__________

NCPG is a 501(c)(3) not-for-profit organization: tax ID #51-0141872.Certain benefits have market value; contributions are tax-deductible in accordance with the