APPLICATION

CENTRAL NEW YORK BLUEGRASS ASSOCIATION

Please print this page, enter the information, and mail to CNYBA at the address shown below.

NAME__________________________________________________________________________

ADDRESS_______________________________________CITY____________________________

STATE___________________________ZIP______________PHONE________________________

E-MAIL ADDRESS ________________________________________________________________

Check here ____ if you are willing to receive the newsletter via email. It saves the Association money and is appreciated.

Choose your membership:

Individual Active ($10)____   Family ($15)____
Individual Senior--62 and older ($9)___   Band ($20)____

For a Gift Certificate, please fill out this form:

FROM_____________________________________

TO________________________________________

ADDRESS___________________________________CITY_____________________________

STATE___________________________ZIP______________PHONE_____________________

E-MAIL ADDRESS _____________________________________________________________

Make checks payable to CNYBA and mail to:

Shirley Stevens
PO Box 536
Liverpool, NY 13088

Members receive a newsletter and other updates. All members can vote on business matters.

 

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CNYBA
PO Box 491
Baldwinsville, NY 13027
www.cnyba.com
Copyright 2002
All Rights Reserved.

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