Membership Application


Please print and fill out. Mail and make $12 check payable to: 
Pennsylvania Gourd Society, PO Box 60714 Harrisburg, PA 17106-0714

Date__________________________ (memberships run from January 1 to December 31)
Please check:   renewal___________    new membership________________

Name______________________________________________________

Street______________________________________________________

City_____________________________State_______Zip_____________

Phone_________________________Email_________________________

May we contact you via email? yes_________no__________

We do not share any contact information with any other organization or company.  We do however provide members with a directory when requested but only for PA Gourd Society related use.  We do not allow the directory to be used for commercial use.


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