Membership Application
Thank You!
The Friends of Grooms Tavern
Ask for Your Help

The work of many minds and hands will lighten the burden and lead to fulfillment of tremendous achievements. You are cordially invited to join with your friends and neighbors in town as we embark on this special trip into the future always remembering the contributions of those who came before us.
Membership Annual Dues Categories
Please print this form, and mail it to the address below,
Thank You for your help.

(please check desired level)

Senior Citizen $10
Individual $20
Family $30
Supporting $50
Associate $100
Patron $250
Corporate $500
Benefactor $1,000


Name_________________________________

Address________________________________

City/Town/Village_______________________

Zip Code______________________________

Phone_________________________________

Date__________________________________

E-Mail_________________________________

Please make checks out to:
Friends of Historic Grooms Tavern Inc.

Mail to:
Friends of Historic Grooms Tavern Inc..
P.O. Box 1166
Clifton Park, New York 12065
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