Step 2: e-Check Authorization Page

If you prefer to pay for your Gold Patriot Membership by electronic check, simply enter your payment information in the below form.  Once you submit the form, your information will be securely transmitted and you will be automatically redirected to the membership signup page to create your account.  Your account will be charged for the one year Gold Patriot membership fee of $60.00.  When your payment has been processed you will receive a payment confirmation email from NAOCS with your receipt.

Name on Check (Last, First)*

Street Address*



Zip Code*

Bank Name*

Routing Number*

Account Number*

Email Address To Send Receipt (Optional)

By checking this box you agree to have your account debited for $60.00(USD) by The National Association of Conservative Seniors in exchange for a one year Gold Patriot Membership. Your information will be kept secure and your account will not be accessed for any other purpose. The yearly membership will not automatically renew with this account. You will be contacted by The NAOCS prior to your yearly renewal date to discuss how you would like to renew your membership.

Enter The Code

*Denotes a required field

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