Yes! I want to support the work of the National Network for Immigrant and Refugee Rights to build a movement to defend and promote the rights of all immigrants and refugees. I understand and agree to the rights and responsibilities of membership as outlined above. I have checked the appropriate dues box on the sliding scale below.

Print out and mail this form along with your payment to the National Network for Immigrant and Refugee Rights at 310 8th St., Ste. 303 Oakland, CA 94607. Checks and money orders can be made payable to "NNIRR."

Individual	$35 (Regular) $20 (Low Income) $10 (Fixed Income/Unemployed)
Organization	$50 (Annual Budget Below $50,000) $75 ($50,000 to $99,999) $100 ($100,000 to $199,999) $150 ($200,000 to $349,999) $250 ($350,000 and up)
	I / We understand and agree to the terms of membership as outlined above (please sign and date):   Signature Date
Name
Organization
Street Address
City, State, Zip
Phone Number
Fax Number
Email Address
Website Address
	Here's a special contribution to support the membership of low income people! $
	Total Amount of Dues Enclosed: $
	Please add me to NNIRR's on-line news list Please add me to NNIRR's fax alert list
	Thank you for your support!