Friends of Science East, Inc. • P.O. Box 552, Shoreham, NY 11786 • (631) 929-8685

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To Become a Member:

  1. Print out the following form
  2. Fill it out completely
  3. Send the completed form along with dues (check or money order) to:
    Friends of Science East, Inc.
    P.O. Box 552
    Shoreham, NY 11786

Contact Information:

Name:
_____________________________________________________
Street:
_____________________________________________________
City:
_________________________ State: _____ ZIP: ___________
Phone:
________________________ Fax: ______________________
Email:
_____________________________________________________

 

Enroll me as:

___ Senior/Student $15
___ Individual $25
___ Family $35
___ Corporation/Institution $200

Please contact me regarding:

___ additional information on giving
___ volunteering

Friends of Science East, Inc. is a not-for-profit, tax-exempt 501(3)c corporation registered with the State of New York. Your contributions are tax-deductible to the fullest extent of the law.