Class C Membership Form

Membership Type *

Class C - Residential Tenant

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

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By checking this box, I understand that I am "E-Signing" this form and that my electronic signature is the equivalent of a handwritten signature. I affirm that I am the Residential Tenant listed above, and I agree to receive emails and other communications from the 161st Street BID. *

I Agree