New Cracow Friendship Society: New Member Application
All applicants must print out and complete the application form “in full” and mail with a check** to :
NCFS c/o Ida Lewis
147-17 78 Rd.
Flushing, N.Y. 11367
**You can pay electronically via secure donate button below. However, completed application must be mailed to address above.
Enclosed please find my new membership application and dues for the calendar year 20 __ __.
Name: ______________________________________________
Maiden _________________________
Mobile Number:________________________ DOB ________________ Circle one: Survivor 2G 3G 4G
Home Telephone Number: _________________________ Anniversary Date: ___________________
Address:________________________________________________________________________________
email address ________________________________
Ancestry names and birth place linked to Galica region: ___________________________________
_________________________________________ ______________________________________________
Spouse’s Name: ______________________________________ Maiden __________________________
Mobile Number: _______________________ DOB: _________ email address: ____________________
Summer/Winter Address: _________________________________________________________________
Other phone number (s):
_________________________________ Months away: _________________
Children’s Names: _______________________________________________________________________
Family Membership: $40.00
Single Membership: $25.00 New Member one time additional fee*:
$50.00
Contribution: ______ $36
______ $54 ______$72 ______$180
______$360 ______other
$_____ Membership +
$ _____ contribution + one time fee*$__50_ = Total $
________
*A one-time initiation fee of $50 is required for new membership enrollment.
_______________________________ ____________
Signature Date
As our membership fees have been increased only once since 1965, so additional contributions are one way to defray operation costs and enable continued philanthropic work as a non profit organization: 501(c)4. All new membership must mail in a complete form and enclose check payable to NCFS or mail in application and submit payment using our secure donation button.
Your
membership information will only be used by the NCFS. Members in
good standing can acquire cemetery plots if available.
More information will be provided upon request.
For further assistance contact the membership committee by mail or by e-mailing. Enclosed please find my membership application and dues for the calendar year 20 __ __.
