Cohoes Caretakers Membership Form

Name:

Title: First:Middle: Last:Suffix:
Title: First:Middle: Last:Suffix:
Title: First:Middle: Last:Suffix:
Title: First:Middle: Last:Suffix:

Address:

P.O. Box: House No. Street:
City: State: Zip Code: Postal Code:
Phone: Fax: Email:

Membership Class:

Each membership class is entitled to one vote. Business, Clubs and Fraternal Organizations please designate the individual authorized to cast your vote.
Title: First:Middle: Last:Suffix:

The Caretakers have several areas where we are currently providing support. Please check any or all areas that you would like to volunteer your time and talents.
Community Events (Concerts, fireworks, tree lighting etc.
Volunteer research, special events)
Work Groups (Canal Square, etc..)
Other:

Print Membership Form with Check payable to Cohoes Caretakers, Inc. mail to:

Cohoes Caretakers, Inc.
P.O. Box 200
Cohoes, NY 12047

Or

Enter information and submit form and you will be contacted.

Harmony Mills Web Co.
Copyright © 1999 [Cohoes Caretakers, Inc.] All rights reserved.
Revised: July 10, 2009 .

Send mail to b4cohoes@nycap.rr.com with questions or comments about this web site. Last modified: July 10, 2009 "Cohoes Caretakers, Inc."