Columbia County Covered Bridges Association, Inc
Dedicated to Preserving the Covered Bridges of Columbia County, Pennsylvania
Membership/Donor Form

Yes, I want to help preserve
the Covered Bridges for our future!


Annual Membership

Individual ...................................... $ 5.00 __

Family ............................................ 10.00 __

Business ......................................... 20.00 __
.

Life Member ................................ 100.00 __

I would like to make a
donation of $ _____________

Please check the level of membership above
and make checks payable to: "CCCBA"

Name _____________________________________

Address ____________________________________

City ________________________________________

State ________ ZIP ___________________________

Phone (_____) _______________________________
E-Mail _____________________________________

Mail This Form to:

Columbia County Covered Bridges Association
529 Zaner-Rohrsburg Road,
Orangeville, PA. 17859
You can print this screen and mail the form to the address shown. Thank You