NAME    ________________________________

ADDRESS ________________________________

CITY, STATE, ZIP _______________________

EMAIL   ________________________________
(to receive notification of events)

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MEMBERSHIPS:

__ Renewal            __ New Member

__ Friend @ $30 =                                      ___         
__ Good Friend @ $50 =                                 ___
__ Very Good Friend @ $100 =                           ___
__ Best Friend @ $250 =                                ___
__ Student/Retiree @ $15 =                             ___
__ Other donation amount - Thank you!                  ___

New members check which FREE map you would like:

__ North Map: Westchester Section
__ South Map: New York City Section.

                                              ============
			          MEMBERSHIP SUBTOTAL: ___

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MAPS

__ North Map: Westchester Section @ $5 =               ___
__ South Map: New York City Section @ $5 =             ___

CLOTHING
(please check our website to see which items are in stock)
Aqueduct T-Shirt @ $20 = 
__ Brown       Size: __ S  __ M __ L                   ___
__ Blue        Size: __ S  __ M __ L  __ XL            ___
__ White       Size: __ S  __ M __ L  __ XL            ___
__ Leaf Green  Size: __ S  __ M __ L  __ Child 8-10    ___
__ Army Green  Size: __ M  __ L  (runs large)          ___
__ Cream       Size: __ Toddler 3                      ___

Aqueduct Baseball Cap @ $20 =                          ___
                                              ============

  				        PRODUCT TOTAL: ___

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SHIPPING AND HANDLING

$.75 for one map, $.50 for each additional map
$ 5 for first clothing item, $2 per additional         ___

                                              ============
  				       SHIPPING TOTAL: ___

                                              ============

                                      ORDER TOTAL:  ___

Mail this form with check or money order to: