or on form above, if you prefer to

www.19WCA.org
The 19th Ward is one of the most diverse neighborhoods in the country. We want our community association
to be representative of everyone in the neighborhood! We encourage people of all racial and ethnic groups
to join the association; whether young or aged, homeowner or renter, we need you!
BE A GOOD NEIGHBOR, GET INVOLVED!
Membership Registration and Contribution Form
The 19th Ward Community
Association
216 Thurston Road
Rochester, NY 14619
(585) 328-6571
19thward@19wca.org
Name ____________________________________________
Business/Church(if registering as a business or church)
__________________________________________________
Address ___________________________________________
City _______________________ State ______ Zip _________
Email _____________________________________________
Phone ______________________
Registration with the 19WCA includes voting privileges at the Annual Convention held the third Friday in November and the Annual
District Meeting if you live within the boundaries of the 19th ward service area.
Registration is required at least 60 days prior to any election.
Registration in the 19WCA is free but the work that we do is not. Please consider making an annual contribution. Registration
includes ten issues of Update 19, delivered via email. Contact the 19WCA office manager if email is inaccessible to you
Annual Contribution Levels
Your financial support is vital in order for the 19WCA to continue to offer programs and activities that improve and sustain the
quality of life in our diverse community.
Please indicate your desired annual contribution level.
Sponsor
Sustaining
Contributing
Family
$250 or More
$100
$50
$35
Individual
Student/Senior
Business/Church
Registration Only
$15
$8
$35
$0 (must live in the 19th Ward)
th
Make checks payable to: The 19 Ward Community Association
Businesses will receive one free annual advertisement in one edition of Update 19.
Please mail or drop off this registration form to the Association Office with your optional contribution check or money order.
If considering making your contribution through the United Way, Use United Way Donor Option #1142
“Be part of the Power of 19”
THANK YOU FOR YOUR SUPPORT!