| Membership: | ____Individual ($15) | ____Family ($20) | ____Patron ($50) | ____Sponsor ($100) |
| Benefactor: | ____Friend ($250-499) | ____Trailmaster ($500-999) | ____Trailblazer ($1,000+) |
Name:________________________________ Phone no.:________________ Mailing Address:________________________________________________
____ I would like to volunteer my time. Please contact me.
Print this form, complete, and send it with your tax-exempt contribution to: TVTA, P.O. Box 1003, Bradford, PA 16701.