Palatine Farmstead Restoration Project

Please accept my membership and/or donation:

□ Donor $1-$49
□ Patron/Yellow Hard Hat $50-$99
□ Benefactor/Yellow Hard Hat $100-
□ Advocate/White Hard Hat $1,000-
□ + other donation of time or materials____________________________

Name _____________________________________________________________________

Address ____________________________________________________________________

              ____________________________________________________________________

              ____________________________________________________________________

Phone _________________________________ E-mail _______________________________

□ Please add my name to the mailing list! 

□ I would like to become an active member of the committee!

□ My employer's matching gift form is enclosed.

Please make your check payable to QRC Palatine Farmstead Committee.

All donations are tax deductible within legal limits for income tax purposes.

Mail this form to:

Quitman Resource Center for Preservation
Ernie Steubesand,  Palatine Farmstead Treasurer
P.O. Box 624
Rhinebeck, NY 12572