Roc NORML New Member Form
After you have made a donation to become a new member, fill out this form so we have your information for our records. Then make sure you come to one of our next events and we'll have your membership package for you to pick up, in person. Please be aware that due to the current size and bandwidth of our organization, we do not currently mail out membership packages; instead we ask that you come to one of our upcoming events and pickup your membership package in person. If this is a problem, please email to see if further arrangements can be made.
Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Membership Level (choose one; go to for more information about membership levels) *
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