First Name:


Last Name:


Address:


Address 2: (Apt #):


City:


Zip:

Telephone:

E-mail Address:


Type of Membership:
 Women Ages 18-64.................................$45.00

 Teen-Age Girls 13-17 .............................$10.00

 Seniors and College Students.................$25.00
With Valid ID

 Men Ages 18-64......................................$45.00
(Men join as Associates)

 Teen-Age Boys 13-17 .............................$10.00
All Children Under 12 participate under a Mother’s membership

 Not-for-profit organizations.....................$250.00
(This membership is available to all 501(c)(3) community based organizations and includes rental fee's of meeting space for the year, schedule permitting)

Type of Card:


Name of Card:


Card Number:


Expiration Date:

For more information on membership please contact:
Yejide Okunribido
Phone: 914-963-0640 ext. 110
Fax: 914-963-7103
admin@ywcayonkers.org