USA East Music NYSB BULLETIN - WINTER 2019/20 | Page 17

new york staff band
2020 ASSOCIATION
MEMBERSHIP FORM
Name
(Mr./Mrs./Rank – the way you want it to appear)
Address
E-mail
Contact Phone Number
Membership Level (check one)
   FRIEND   BRONZE BATON
    SILVER BATON   GOLD BATON
    PLATINUM BATON
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.