Membership Application Form

Fill in this information. We will generate a Membership Application Form for you to print and send in with your payment. Thank you.

Friends of Hope Lodge is a certified 501 (c) (3) non-profit organization and is registered by the Bureau of Charitable Organizations. The estimated value of benefits received by your membership donation allows the entire amount to be used as a tax deductible contribution. See a tax advisor for complete information.

Name
Address
City / State/ ZIP
Telephone
E-mail
Membership	New Renewal
Level	Individual $20 Family $35 Patron $50 Sponsor $100
Optional	Membership to PA Heritage Society +$21 What is this?
Matching	My contributions will be matched by my employer.

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Membership Application Form