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Stuyvesant Park Neighborhood Association, Inc.

MEMBERSHIP APPLICATIONS
I (we) hereby apply for membership in the Stuyvesant Park Neighborhood Association.
Enclosed is $__________ for annual dues.  Total amount of enclosure: $__________.
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.