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SEAC Membership

Your membership is required to keep SEAC working for you

Please print this form,
fill in the appropriate blanks 
and send it with your dues to:
SEAC
1045 South Clinton Avenue
Rochester, NY 14620
Name ___________________________________ Neighborhood _________________

Address ___________________________________________________ Zip ________

Phone # - day ________________ evening ______________

E-mail _________________________________________________________________

Membership Category
Please circle your membership level


Patron
($250+)
Household ($25-$49)
Business ($50-$100)
Seniors & Students ($5-$24)
Members receive SEACommunications ten times a year, may borrow tools and equipment from the tool library, are eligible to join the Genesee Co-Op Credit Union, and are appreciated as really GREAT neighbors!
I am a (Please circle one!)     Business     Homeowner     Landlord     Tenant

My special concerns are  __________________________________________________

_______________________________________________________________________

_______________________________________________________________________

I would like to volunteer to ________________________________________________

_______________________________________________________________________

_______________________________________________________________________