Palisades Community Center
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Palisades Community Center 
Membership & Donation Form

(print and mail)

YES!  Sign me up!     
_____   $35 individual membership   _____   $50 family membership   _____   $20 senior citizen membership 

Members receive a discount on rentals and special events AND
a coupon for 
two Balthazar Pain au Chocolat. 
(Redeemable at the Palisades Winter Farmers' Market)


In addition, I would like to contribute to the Restoration Campaign.
____$25   ____$50   ____$100   _____$250    ______$500  _____ $1,000  ___________ other

EXTRAS:
____  “10964” Mug  @ $25 each = $_______   (sold out)
____   Palisades Pots & Pans Cookbook @ $20 each = $ ______ (while supplies last)
____   Palisades Photographers Photo Cards set @ $25 = $______ (while supplies last)
____   Palisades Community Directory @ $15 each = $ _______
____   Palisades Farmers' Market Tote Bag @ $15 each = $ _________

 TOTAL (Membership/Donation/Extras):  _____________                         
                                       THANK YOU for your investment in our community!

Make checks payable to:
Palisades Community Center, INC
PO Box 222
Palisades, NY  10964

             The Palisades Community Center, INC is a 501 (c)(3) not-for-profit organization.
                               Your donation is tax-deductible
to the extent allowed by law.
Name: 
_______________________________________________________

Address:  
_________________________________________________________

E-mail: ___________________________________________________  

Phone: ___________________________

________ Yes, I’d like to volunteer               ________ Yes, I can donate my services
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