MEMBERSHIP

APPLICATION for MEMBERSHIP in KNGG

MEMBERSHIP APPLICATION

Kinderhook Neighbors for Good Growth, Inc.

P. O. Box 370

Kinderhook NY 12106

www.KNGG.org ~ 518 758-2646 ~ KNGG@berk.com

 

Yes! I want to RENEW my KNGG Membership for 2007__

or

Yes! I want to JOIN KNGG for 2007 __

Name _______________________________

Address _____________________________

Town, State, Zip Code ________________________________

Night telephone ________________Day Telephone _______________ E-mail _____________

Signature   X __________________________  Date ____/____/____

 

Rejoining/Joining KNGG helps keep KNGG operational

(Telephone, fax e-mail, web site, office supplies etc.) 

 

2007 MEMBERSHIP LEVELS

Please check one below:

Individual $25 ___            Sponsor $100 ___         Other $ ____

Family $50 ___                 Benefactor $250 ___

 

TOTAL:

For 2007 KNGG Membership $_______

In addition to my membership level checked above,

          I wish to contribute $_______ 

MY check total is $______

 

Please make your check payable to KNGG

KNGG is a 501[C] [3] not-for-profit Corporation.

Your contribution is tax deductible as allowed by law.

Your contribution to KNGG will help us continue to fight badly

planned development, and to work with our local officials

to succeed in our mission.

 

Thank you!