New Membership | Cutchogue Civic Association

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New Membership Application

Registration and payment may be done online or by regular mail:

*ONLINE: Fill out and submit the online membership form below and click HERE to submit the credit card payment.

*REGULAR MAIL: Click HERE to print and fill out the membership form. Enclose the form and check and mail according to the instructions on the form.

Name *

First

Last

Email *

Mailing Address - Street *

Mailing Address - Town/City *

Mailing Address - State *

Mailing Address - Zip *

Street Address (if different from mailing address)

At this address, I am a: *

Renter (residence)
Homeowner
Business

Phone *

Alt Phone

Membership Type *

New
Renewal
Gift

Membership Class

Individual ($25)
Family ($40)
Business ($55)
Friend (non-resident of Cutchogue) ($15)

Our civic association relies on active participation by our members! Please consider joining a committee or serving in a leadership role:

Board of Directors

Committees:

Communications
Membership
Governmental Affairs
Programs

What skills do you have that would contribute to the success of the Cutchogue Civic Association (e.g., website technology)?

If you have any questions, please contact us:

Email: CutchogueCivic@gmail.com
Mailing Address: Cutchogue Civic Association, P. O. Box 1103, Cutchogue, NY 11935

OUR MISSION
The CUTCHOGUE CIVIC ASSOCIATION is a not-for-profit, community-based organization
whose mission is to inform and educate residents about issues of community interest or
concern. We provide a neutral forum that promotes discussion, collaboration and the
expression of diverse ideas.

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