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APPLICATION FOR USE OF THE TOWN OF ULSTER SENIOR CENTER

Reset Signature
Signature is required.
Must be resident's signature if requesting resident rate
Copy of utility or tax bill
Copy of utility or tax bill

Please remit payment and any supporting paperwork to the Town Clerk’s office as soon as possible to ensure your reservation.

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FOR OFFICE USE ONLY

Security Deposit:

Cash _________ Check # ________

Returned ________ Destroyed ________

Rental Fee:

Cash ____________ Check # __________ Charge ___________________________

Authorized By: _________________________________________________________