SRNY Membership Inquiry
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Name
*
First Name
Last Name
Email
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example@example.com
Phone Number
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Area Code
Phone Number
If you have a relative that is or was a member of the SRNY, enter their name here:
Name of Patriot Ancestor, if known
How did you hear about the SRNY? Were you referred by someone, and if so, who?
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Additional Information:
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