Membership Form

Help save costs and resources by submitting your membership form online! Simply fill out this form and then click "Submit". Next, supply us with payment information by using your preferred method:

1) PayPal: Safe, fast, and secure payment method! Use our site to pay your dues and avoid the hassle of writing and mailing a check!

2) Check: If you prefer, you may still send us a check! Send your check, payable to "CCWA", in the amount due, to:

CCWA

P.O. Box 2881

York, PA 17405-2881

*Be sure the information on or with your check matches the information submitted with the online form!

You can also print out, complete, and mail the preprinted form at the bottom to us, with the check, if you prefer.

Regardless of payment method, we will send you a confirmation to let you know your membership has been processed! (Please allow at least 1 - 2 weeks for processing.)

THANK YOU!

First Name
Middle Initial
Last Name
Street Address
City
State
Zip Code
Phone
Email Address
Choose Membership Level
Please list any concerns you have for the Codorus Creek Watershed
Please list any talents, abilities, etc. that you are willing to use to help us
Please list any comments you want us to see

CCWA MEMBERSHIP FORM

General Information

Name:___________________________________________________________

Address:_________________________________________________________

City, State, Zip Code:_______________________________________________

Phone:___________________________________________________________

E-mail:___________________________________________________________

Membership Options

Options	1-Year	2-Year
Individual	$10	$18
Group	$25	$45
Student/Senior	$5	$7

Tell us what your concerns about the Codorus are:

Tell us what talents and skills you can offer to help CCWA:

Make check payable and mail to:

Codorus Creek Watershed Association

PO Box 2881

York, PA 17405

Thank You!