Alumni Association - Pay by Check

Annual membership in the Alumni Association is $20.00. Membership entitles you to full participation in the decision making process, annual voting privileges, a copy of our By-Laws and any future Alumni mailings.

Please print this page, fill out the information requested, and send, along with a $20.00 check payable to Samaritan Alumni Association to:

Samaritan Alumni Association
138-02 Queens Blvd.
Briarwood, NY 11435

Name ___________________________________________

Address _________________________________________

City _______________________ State _____ Zip _______

Telephone (Day) _____________ (Evening) ____________

Samaritan Village AlumniSamaritan Village Alumni