New York Staff Band 440 West Nyack Rd West Nyack NY 10994 – 1739
NEW YORK STAFF BAND
2024 – 25 ASSOCIATION
MEMBERSHIP FORM
Name
( Mr ./ Mrs ./ Rank – the way you want it to appear ) Address
E-mail
Contact Phone Number
Membership Level ( check one )
Visit NYSB . ORG for more information
FRIEND SILVER BATON PLATINUM BATON
BRONZE BATON GOLD BATON IN MEMORIAM of
( NAME OF INDIVIDUAL )
Make a check payable to “ The Salvation Army ”
Check # _____________________________________ Amount $ ____________________________________ Date of Check : ________________________________
OR MasterCard / Visa / American Express
Exp . Date ( MM / YY ): _____ /_____ Security Code ( CVC Code ): __________
Using the envelope provided , please submit this form and payment to :
The Salvation Army New York Staff Band Association 440 West Nyack Road West Nyack , NY 10994
or visit our website www . nysb . org to donate or become a member .