Museum Association of New York

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INSTITUTIONAL MEMBERSHIP JOIN/RENEW

Yes, I am pleased to join/renew our membership and join with other organizations to strengthen and support the museums of New York State. Please make remittance payable to the Museum Association of New York.

My institution's current operating budget is $

Membership Fees:

Membership continues for 12 months from the date of renewal.

[ ]	Budget under $50,000:	$55
[ ]	Budget $50,001 - $100,000:	$80
[ ]	Budget $100,001 - $500,000:	$125
[ ]	Budget $500,001 - $1,000,000:	$150
[ ]	Budget $1,000,001 - $2,500,000:	$240
[ ]	Budget $2,500,001 - $5,000,000:	$350
[ ]	Budget over $5,000,000:	$450
[ ]	MANY Institutional Sponsor:	$500

Please complete the following in order that we may update our files:

Name of Director/CEO

Name & Title of Contact Person

Institution Name

Mailing Address

County Telephone Ext.

Fax Email

Website address

The following information assists us with advocacy work:

For the most recently completed fiscal year:	# of members
	annual attendance
Chartered by the State Board of Regents?		Yes No
Date of Permanent Charter
Congressional District
State Senate District
State Assembly District