Name
________________________________________________
Address ________________________________ Apt. __________
City _______________________ State ________ Zip __________
Tel (_____)__________________ Fax (_____)________________
E-mail ________________________________________________Please
make checks payable to the Stuyvesant Park Neighborhood Association, Inc.
and mail to
P.O. Box 1320, Cooper Station New York, New York 10276 |
q
$5.00 - Senior Citizen/Student
q $10.00 - Individual
q $15.00 - Family
q $20.00 - Business
q $50.00 - Institution
(suggested contribution)
q Additional Contribution $_____All
dues and contributions are
tax-deductible to the extent the law allows. |