If you haven't already, print out the application below and mail it to:
| Waymart Volunteer Ambulance Corps |
| Fund Drive 2008 |
| Po Box F |
| Waymart, PA 18472 |
| Waymart Volunteer Ambulance Corps | Subcription Fee is only | |||||||||||||||
| Fund Drive 2008 | $45.00 per year for | |||||||||||||||
| Po Box F | Full Ambulance Coverage | |||||||||||||||
| Waymart, PA 18472 | (Check Fund Drive Letter for Details) | |||||||||||||||
|
Subscription Program |
Check box to become | |||||||||||||||
| Good from August 2008 - August 2009 | a member for | $45.00 | □ | |||||||||||||
| Business | $250.00 | □ | ||||||||||||||
|
Name____________________________ |
(If you wish to make a donation less than $45.00, please enter amount below) | |||||||||||||||
| Address__________________________ | $_______________________________________ | |||||||||||||||
| Town___________State___Zip________ | (Please note donations less than $45.00 are not considered a membership) | |||||||||||||||
| Phone Number (Optional)_____________ | Please make checks payable to | |||||||||||||||
| Waymart Volunteer Ambulance Corps | ||||||||||||||||