Membership form -- please print and mail to
St. George Civic Association
P.O. Box 987
Staten Island, NY 10301

Membership dues for two years:
Individual $20
Family or business $30
Please make checks payable to St. George Civic Association

Name______________________________________________________________________________________

Address____________________________________________________________________________________

__________________________________________________________________________________________

Phone_____________________________________________________________________________________

e-mail address______________________________________________________________________________

Would you like to participate in our web discussion group? ____ Yes ____No

Please check here____if this is a renewal.

Information is used only by the SGCA for official purposes, and is never loaned or sold to others.

Thank you for being a member of the St. George Civic Association!