Name: ___________________________________ Today's Date: _________________________
Address: _________________________________ Home Phone: _________________________
City: _____________________________________
State: __________________________ Occupation (optional): ____________________________
Zip Code: _____________-_________ E-mail (optional): ________________________________
I apply for membership in the Electric City Trolley Museum Association, as follows:
________ Sustaining ($25.00 per year)
________ Associate ($20.00 per year)
________ Family ($35.00 per year)
List family names: ________________________________________________________________
The Electric City Trolley Museum Association is recognized as a 501(c)(3) organization and contributions are tax deductible to the extent permitted by law.
The official registration and financial information of Electric City Trolley Museum Association may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement.
Contribution $__________________________
Total Remitted $__________________________
My check is enclosed. I agree to abide by the duly enacted By-laws and Rules and Regulations of the Electric City Trolley Museum Association while involved in all organizational activities.
I agree I will not use the name of the organization in any way that will obligate the organization or any of its members without due authorization.
Signed: ________________________________________________________
Please make check payable to: Electric City Trolley Museum Association (ECTMA)
Please mail to: ECTMA Treasurer; 227 Locust Road; Fort Washington PA 19034