Philadelphia Chapter Membership Form
Please print and complete this form and return it with your check payable to
Philadelphia Chapter: Lewis and Clark Trail Heritage Foundation
P.O. Box 39534
Philadelphia, PA 19136-9534

Annual Membership Categories
Regular ~ $17. Individual member with one vote. Must also be a member of the national LCTHF.

Household ~ $25. Group membership with two votes per household. Both must also have membership in LCTHF.

Supporting ~ $15. Individuals interested in supporting the Philadelphia Chapter, but with no vote. Membership in the LCTHF is not required. (Not covered by insurance which LCTHF carries on its members.)

Name(s) __________________________________

Address ________________________________

City ____________ State ___ Zip ______

Telephone __________________

Email _________________________

Membership Category: ______________

Thank you!