Hudson Valley 10-13 Multiform

Please use the NEW Multi-form to pay your dues online and/or donate!

Name (*Required)

Email Address (*Required, Please Enter Your Preferred Email so we have this on file)

Phone Number (*Required, Please Enter your preferred Phone Number so we have this on file)

Member Number - **OK to leave blank if you don't have it**

Membership Dues

Membership Dues - 1 Year – $35

Membership Dues - 2 Years – $70

General Fund

Bible Fund

Other

*If OTHER, please specify what your donation is for.

MESSAGE AREA - Please add any comments you would like us to know