The New York Caledonian Club, Inc.
Membership Application

(1) Fill out this form. (2) Print it for your records. (3) Click on the [Submit] Button to complete.

Date:	May 11, 2008
Type:	New Member     Renewal
Membership:	Individual     Student     Senior     Family/Houshold     persons. Please type the names of the other person(s) in the Comments box below.
Your Name:	Dr. Mr. Ms. Mrs. First:     Last:
Address:	City:     State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington,D.C. West Virginia Wisconsin Wyoming     Zipcode:
Phone:	Ext. Home     Office     Cell Best time to call: Morning     Afternoon     Evening
Email:
Age Range:	1-18     19-35     36-45     46-65     65+
Payment:	Check    M.O.   of $
Newsletter:	E-Mail(.pdf)    Mail (Printed) Please consider receiving our Newsletters, and other printed material by E-Mail rather than by USPS Mail. This will help us keep our costs lower.
Comments: (not required)
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Mail your Check or Money Order to:
Membership Dept.
The New York Caledonian Club
P.O. Box 4542
Grand Central Station
New York, NY 10163-4542