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CANAL SOCIETY OF NEW YORK STATE

Membership Application Form
(click for a form in pdf format)

Please enroll me/us in the member classification noted below.

I have enclosed $ __________ dues.____

Please check category

 

Individual

$25.00

 

Family (husband and wife/parent and child)

$35.00

 

Sustaining annual dues

$40.00

 

Institutional annual dues

$50.00

 

Name:

Street:

City:

State:

Zip:

Phone(Home):

Business:

Business or Profession:

Business Address:

 

Introduced By:

Mail a copy of this form with check payable to the Canal Society of New York State to:

Anita Cottrell
Secretary-Treasurer
7308 Jamesville Road
Manlius, New York 13104

 

 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   

               

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