Join the West 104th Street Block Association

Membership Form

We have activated a Paypal form so you can pay online by credit card. You can also mail in your dues by using the form below.

Dues Amount
I would like to allocate my dues to:

You can also mail in your membership dues. Please print the form and mail us the membership form below with a check.

Amount of check: ________ (suggested dues $40 quarterly, $160 per year)

Please allocate my contribution to:

___ Security

___ Beautification

___ Social

___ Newsletter

___ Board decision

Name ______________________________________________________________________

Address ________________________________________________ Apt Number ________

Email Address _______________________________________________________________

Phone ______________________________________________________________________

Suggestions for the block: ____________________________________________________



Make checks payable to “West 104th Street Block Association”

Mail to our Treasurer:

Barbara Boynton
905 West End Avenue, Apt #71
New York, NY 10025

Or drop off at one of our member buildings.
895 West End Avenue: Grannis, Apt. 8B
320 Riverside Drive: Waskow, Apt 8G
315 Riverside Drive: Howitt, Apt 8C
309 West 104th Street: Mann, Apt 3A

Print form