Friends of the Pike County Public Library

Annual Membership Form

The following are guidelines. Please feel free to contribute whatever is appropriate for you.

 Corporate Sponsor $______

 Sponsor   $______

 Patron $50

 Family $25.

 Individual $20

 Junior (under 18) $10

 Other $____________

 

*Required fields to be filled out below.

Name 

*

Mailing Address 

*

City

*
.

State 
*                      

Zip 

*

E-mail 

Phone 

*

 

Please indicate if:

________  New Member    ________New Address    ________New Telephone

Please indicate here if you have a second (winter/summer) address that you which to have your newsletters mailed to for July & January.

Street Address:  _____________________________________________

City  ______________________________________   State _________________________  Zip  _______________________

Yes, I'd like to volunteer:

  working at Book Sales and Special Events

  working in the Book Room

  to help sort and shelve donated books. "book worm"

  assist with the mailings

  Check here if you would prefer to receive the newsletter via email.

Fill out this form, make your check out to: Friends of PCPL

Mail to:
Friends of Pike County Public Library
PO Box 80
Milford PA 18337-0080

Dues are from January 1 through December 31. Your contribution is tax deductible.