Washington Crossing Foundation Membership Form
Name  
Address  
City  
State  
ZIP  
Phone  
(  ) ANNUAL MEMBERSHIP $35.00
(  ) PATRON           $50.00
(  ) RED, WHITE & BLUE $100.00
(  ) PATRIOT        300.00
(  ) FLAG WAVER $500.00
(  ) STARS & STRIPES $750.00
(  ) CORPORATE SPONSOR $1,000.00
(  ) LIFE MEMBER $2,500.00

Make checks payable to :
Washington Crossing Foundation
P.O. Box 500
Bristol, PA  19007

Phone 215-949-8841    FAX 215-949-8843

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