MEMBERSHIP APPLICATION

CONSERVATION ALLIANCE OF NEW YORK
P.O. Box 39 (mail), 647 Delaware County Route 11 (shipping)
WEST DAVENPORT, NY 13860
(607) 432-4416

Instructions: Fill out the form online and then print it out.

Select one:

New Member Renewal (CANY # )

Name:

Address1:

Address2:

City:

   State:    Zip: -

County:

       Phone: ( )-

E-mail:

Date of Birth:

(Month/Day/Year) / /

GENERAL MEMBERSHIP CATEGORIES

General Member (17 years of age and older) - 1 year @ $15.00

Junior Membership - Junior members (16 years of age or younger) pay annual dues at a rate set by the Board and may not vote. The initial dues are set at $5.00.

Sportsmen's Club - $1 per member per year for each member of the Club, up to a total of $250.00. However, that amount will be adjusted based upon the number of Club members who join CANY. For example, if 10% of the Club's members become members of CANY, the Club's dues would be reduced 10%. If 100% of the Club's members become members of CANY, the Club would pay no dues, and still have the rights, privileges, and responsibilities of a "Sportsmen's club Member".

Life member - any individual that makes a one-time payment, either in full or in specified installments, of an amount specified by the Board. The initial fee established by the Board is $300.00.

Contributing Membership - Contributing members support CANY's mission and make annual contributions of funds or in-kind services at or above an amount specified by the Board. The initial annual amount established by the Board is $500.00.

Endowment Members - the initial dues established by the Board for Endowment Membership are set at $1,000.00 per year.

BOARD AWARDED MEMBERSHIPS

Allied Organization (Share CANY's vision, elected by Board) - 1 year @ $150.00.

Champion Membership - Publicly active General member who is recognized by the Board as a "Champion" for the conservation of the State's renewable natural resources and given a free one-year General Membership.

Honorary Life Membership - The Board may convey the title of "Honorary Member" to any individual it feels embodies what CANY is about. Such members will no longer pay annual dues and will have all the privileges and responsibilities of General Members.

PLEASE INDICATE YOUR METHOD OF PAYMENT:

Cash, Check or Money Order made out to CANY