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CANAL SOCIETY OF NEW YORK STATE |
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| 1 yr | 2 yr | |||
| __ Individual annual dues | $30.00 | $60.00 | ||
| __ Family annual dues | $40.00 | $80.00 | ||
| __ Sponsor annual dues | $45.00 | $90.00 | ||
| __ Patron annual dues | $55.00 | $110.00 | ||
| __ Sustaining annual dues | $100.00 | $200.00 | ||
| __ Benefactor annual dues | $250.00 | $500.00 | ||
| __ Corporation annual dues | $300.00 | $600.00 | ||
| __ Additional Contribution | ||||
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The Canal Society
of NYS is recognized by the IRS as a tax exempt 501(c)(3), non-profit |
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| Name:__________________________________________________________________ | ||||
| Street :__________________________________________________________________ | ||||
| City:_______________________________ State:___________ Zip:_________________ | ||||
| County:___________________________________Country:______________________ | ||||
| Phone (Home):_________________________________Business:________________ | ||||
| Business or Profession:__________________________________________________ | ||||
| Email:__________________________________________________________________ | ||||
| How did you hear about us?_______________________________________________ | ||||
| Know anyone who might like to join? We would be happy to send information to them! | ||||
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_____________________________________________________________________ |
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Mail a
copy of this form with check payable to the Canal Society of New York
State to: |
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