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Historic Langhorne Association Membership Application.

Print the form, fill in the information and return it with your check payable to

HISTORIC LANGHORNE ASSOCIATION.

Mail to: Historic Langhorne Association- 160 W. Maple Ave. - Langhorne, PA 19047

Name___________________________________________________________

Address________________________________________________________

________________________________________________________

Phone _____________________ E-mail address____________________

Individual Membership $20.00 __________

Family $25.00 __________

Patron Group $50.00 __________

Century Group $100.00 __________

Worthington Associate $500.00 __________Includes embossed 4" x 4" tile and a household membership

Williamson Lifetime $1000.00 __________Includes the embossed tile and a household membership

Contributions to HLA, a 503(c)3 organization, are tax deductible to the extent permitted by law.

Yearly memberships run from September through August.