MEMBERSHIP APPLICATION

Name:__________________________________________________________________________________________

Address:________________________________________________________________________________________

_____________________________________________________________________________Zip Code___________

Phone (Area Code)________________________________E-Mail___________________________________________

 

Memberships: _____ $15 Individual; _____ $20 Family; _____ $50 Contributing Member;

_____ $100 Annual Donor; _____ $500 Patron; _____ $600 or more Benefactor.

Please make checks out to the Pahaquarry Association for History and the Arts, Inc. (PAHA). Send checks to PAHA, Inc.,

P.O. Box 241, Hope, NJ 07844. Thank you for your support.