Foundation Membership Order Form
[ ] Enclosed is my Lifetime Foundation Membership fee of $200.00 [ ] Enclosed is my Annual Foundation Membership fee of $20.00
Total Enclosed: _______________
Name (Include Maiden): _______________________________________________________
Address: ____________________________________________________________________
City, State, Zip:_______________________________________________________________
Telephone Number: _______________________________ Class of: ___________________
E-Mail Address _______________________________________________________________
Please make checks payable to: The New Dorp High School Foundation, Inc.
Mail your check and order form to: The New Dorp High School Foundation, Inc.
c/o New Dorp High School
465 New Dorp Lane
Staten Island, NY 10306
Not-for-Profit Corporation