The National Alliance
                  APPLICATION FOR MEMBERSHIP

ELIGIBILITY STATEMENT:

I am a White person of good moral character, with no
disqualifying characteristics. I have familiarized myself with
the goals and the program of the National Alliance and I am in
agreement with them. I want to participate in the Alliance's
effort to build a secure and healthy future for my race by
becoming a member. I will pay the monthly dues I have
indicated below. I am enclosing my first month's dues plus
my $15 application fee.

Applicant's signature:______________________ Date:_______


SELECTION OF MONTHLY DUES LEVEL:

Applicant should indicate his dues level in the space below, in
whole dollars, as high as means permit. The monthly minimum is
$10. A member may elect to pay monthly or for as many months in
advance as desired, e.g., on a quarterly basis.


Amount of monthly dues: $_____ , plus $15 application fee.
TOTAL enclosed: $ _____

May we give your name and address/telephone to a trusted
member in your area?  [ ] Yes      [ ] No

Were you contacted or given information about the National
Alliance by a member? [ ] Yes      [ ] No    If "yes" what
is the member's name? ____________________________
If "no" how did you learn about the National Alliance?
__________________________________________________________

Your name_________________________________________________
Address___________________________________________________
City________________________ State____________ Zip________
Date of Birth____________ Sex______ Marital Status________
Occupation________________________________________________
Telephone_________________________________________________
E-mail address:___________________________________________

Mail completed application (must include check or money
order) to:

NATIONAL ALLIANCE
PO BOX 90
HILLSBORO WV  24946
USA