YWCA Cortland

One moment please...

Annual Membership Info and Payment Form

As a member of YWCA Cortland, you join our efforts to eliminate racism, empower women, and promote peace, justice, freedom, and dignity for all. 
You add your voice to a diverse and powerful sisterhood of 25 million women in 120 countries worldwide.
Your annual membership supports community programs and advocacy efforts to further our mission–a mission that we can't accomplish without you!
Contact Information
If you are renewing your membership, you may have already provided us with the following details. However, completing it again will ensure we have your current contact information and membership details, allowing us to provide you with the best customer service possible.

(mm/dd/yyyy)


Provide the phone number at which you prefer us to contact you. You can provide up to two additional phone numbers at the bottom of the page.

Provide the email address at which you prefer us to contact you. You can provide up to two additional email addresses at the bottom of the page.
*

Want to Know What's Happening at the YWCA?

Click here to subscribe to our monthly email newsletter and ensure you receive other emails about all the events, classes, and programs happening at YWCA Cortland!

Emergency Contact Information

Please provide information for your preferred contact so we can better assist you in an emergency.



Membership Options
We offer “Supportive Membership” for mission-passionate members who wish to support the programs of the YWCA at an increased amount per year. Enrolling in this membership is a statement of your support of the mission of YWCA Cortland to eliminate racism, empower women, and promote peace, justice, freedom, and dignity for all.
If you would like to pay for a Family or Student membership, please do so at the YWCA at 14 Clayton Ave., Cortland, NY 13045.
Demographic Information
Providing the following information is voluntary. Failure to complete it will not affect your membership, nor is the information used for employment purposes. However, we would appreciate your cooperation in providing this information, enabling us to serve you and our other members better.
Select all that apply.

Please enter your response if you selected "Other" above.
Select all that apply.
Do you have any condition(s) which require special accommodations?

Children Under the Age of 12
If you have children 12 years of age and younger participating in our programs, please provide their names, birthdates, and genders below.

(mm/dd/yyyy)

(mm/dd/yyyy)

(mm/dd/yyyy)

(mm/dd/yyyy)

(mm/dd/yyyy)
Additional Phone and Email Contact Information

Optional

Optional


Optional

Optional

YWCA_logo.jpg YWCA_MISSION_STACKED_RGB.png