RAYNOR
FAMILY ASSOCIATION
10 Girard Place
Merrick, NY 11566
Email address:
[email protected]
Today's
Date: _____________________
(membership
year is from October to October)
Name:
____________________________________________________
Street:
_____________________________________________________
City,
State & Zip: ___________________________________________
Phone:
______________________ E-mail: _______________________
Active
or Associate Membership: New _____ Renewal _____
*Individual
($10.00) _____; Family ($15.00* one household) _____.
Individual
Sustaining Membership ($25.00) _____; Individual Life Membership ($150.00)
_____.
*If Family
Membership, please write all the names of those you wish to include with
this Annual Dues form, and their relationship to you. In this instance,
the term "family" refers to those living in one household.
*IF YOU
ARE AN ASSOCIATE MEMBER, (friends of the Raynors), PLEASE CIRCLE THE WORD
"ASSOCIATE" ABOVE.
MEMBERSHIP TOTAL ENCLOSED $_____________
(Make checks payable to the Raynor Family Association)
If
at any time, you wish to pay for another persons' annual dues, outside
your own family membership unit, please indicate and include a separate
dues form, or the full name and address of that person or persons and type
of membership with the check.
Thank
you very much,
Jeanne
Raynor
Membership
Chairperson
.
Please
click above for additional information.
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