Welcome to the National Association of Social Workers – Missouri Chapter, the premier social 
work organization, representing 2600 professionally degreed social workers across Missouri. 

NASW-Missouri Chapter invites your company, agency or organization - one that upholds social work and quality social values and aligns with NASW-Missouri Chapter’s public policy positions and Code of Ethics – to participate in its Supporting Organizations Program.

GOLD LEVEL

Free Subscription of the Chapter’s official newspaper, The Missouri News, with recognition as an NASW-Missouri Chapter Supporting Organization’s Program Gold Level Member. 
Retail Value: $65.00/year 

Free Link with NASW-Missouri Chapter’s official website. 
Retail Value: $100.00/year 

One Free exhibition at NASW-Missouri Chapter’s annual conference. This includes recognition in all registration materials and conference brochures. 
Retail Value: $175.00 (non-profit rate) $250.00 (for-profit rate)

One Free registrant at NASW-Missouri Chapter’s annual conference.
Retail Value: $350.00 (member rate) $400.00 (non-member rate)

One Free color ½ page advertisement in the Chapter’s official newspaper, The Missouri News. 
Retail Value: $250.00 

Total Retail Value: $940.00-1065.00
NASW-Missouri Chapter Supporting Organization Gold Level Member Cost: $700.00 
Annual Savings: $240.00-365.00! 

Your cost to participate in NASW-Missouri Chapter Supporting Organization’s Program at the GOLD Level is only $700.00 a year. With a retail value of $940.00-1065.00 a year, we offer a significant savings to our Supporting Organization Program members!

NASW-MISSOURI CHAPTER SUPPORTING ORGANIZATIONS APPLICATION FORM

Thank you for participating in NASW-Missouri Chapter’s Supporting Organizations Program (SOP). Please provide the information requested and submit this form along with your payment to the address listed below.

ORGANIZATION INFORMATION

Name of Organization:________________________________________________

Address:____________________________________________________________

City:_________________________ State:________________ Zip Code:_____________

Phone Number:_______________________________

Fax Number:_____________________________

Web Address:_________________________________________________________

CONTACT INFORMATION

The primary contact is the recipient of participant information. The secondary name is for contact purposes only.

** Primary Contact Name:_________________________________________

    Title:________________________________________________________ 

    Address:________________________________________________ 
    (if different from above)     

    City:____________________________ State:_____________ Zip Code:_____________

    Phone Number:______________________________________________

    Fax Number:________________________________________________  
   
    E-Mail Address:__________________________________________________________

** Secondary Contact Name:_______________________________________________

    Title:________________________________________________________ 

    Address:________________________________________________ 
    (if different from above)     

    City:____________________________ State:_____________ Zip Code:_____________

    Phone Number:______________________________________________

    Fax Number:________________________________________________  
    
    E-Mail Address:____________________________________________________________

PARTICIPANT LEVEL OPTIONS:   (circle one)     GOLD ($700.00)     SILVER ($500.00)

PAYMENT INFORMATION

___Payment by check.(Please make your check payable to NASW-Missouri Chapter)

___Payment by credit card.(circle one)  VISA    Mastercard    Discover    American Express

Credit Card#:_____________________________________________________________

Exp.Date:_________________________  CVV (3-Digit Code on back):_________________

Name on Card:______________________________________________________

Cardholders Signature:_______________________________________________