Membership Form - Print this page
Yes! I would like to join SA! My Membership fee/contribution is enclosed.

 Organizational Member $ 100
 Individual Member $ 10
 Self-Advocate Member $ 0, please sign-up here and pay dues to your local SA group.
 Additional Donation (Thank you!) $_______

Please make checks payable to Self-Advocacy.

Thank you for helping make our voices count!

ALSO – Our Mailing List needs your help: please fill-in the following information - thank you!

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About You...
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Please Send Completed Form to:
Self-Advocacy Association of New York State, Inc.
Capital District DSO, Building 5
500 Balltown Road, Schenectady, NY 12304