SAI New York Alumnae Chapter 2019-2020 Membership Form
Last Name *
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First Name *
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Middle Name
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Maiden Name
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Address 1 *
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Address 2
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City *
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State *
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Zip Code *
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Cell Phone
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Home Phone
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Birthday *
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Email *
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Emergency Contact
We get worried when we don’t hear from our members on a regular basis. We will always try to reach members by the contact information they have given us. However, in the rare case we aren’t able to reach a member for a significant period of time, we are asking members to please provide an emergency contact (including name and phone number). This will remain confidential—only the NYAC Executive Board will have access to it. An emergency contact can be ANYONE, ANYWHERE that we can contact in order to find out if a member is okay. This section is optional.
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