THE ANCRAM PRESERVATION GROUP

 

MEMBERSHIP FORM

 

 

YES I want to help preserve the historic character and rural beauty of Ancram.

 

Member - $25

 

Family - $35

 

Friend - $100

 

Supporter - $200

 

Patron - $500

 

Benefactor - $1,000

 

Other: Amount $_______________

 

NAME:

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ADDRESS:

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CITY:

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STATE:

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ZIP:

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PHONE:

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EMAIL:

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All contributions are deductible from income for the purposes of Federal Income Tax to the full extent provided by law.

 

The Ancram Preservation Group PO BOX 177 Ancram NY 12502