join & renew North Stamford Association P.O. Box 16830 Stamford, CT 06905 The North Stamford Association is solely dependent upon member dues to fund programs and to continue working on your behalf. Membership Donations are for the Year: JANUARY 1 - DECEMBER 31. To join or renew, fill out and submit the form below -- or if you would prefer to pay by check simply make your check payable to The North Stamford Association and mail to: North Stamford Association P.O. Box 16830 Stamford, CT 06905 Please provide the following information: Name, Address, Phone, E-Mail Friend $25 Sponsor $50 Patron $100 Benefactor $125 and aboveMembership*I am a new memberI am already a member and am renewing my membershipMember Number (if known)Please enter a value between 0 and 10000.Donation for membership*Select a membership levelFriend - $25Sponsor - $50Patron - $100Benefactor - $125 or aboveBenefactor donation amount* Your total donation $0.00 Name* First Last Address* House Number Street City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Payment Method*Credit CardCheckCredit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name
