Williamsport Lycoming Arts Council 220 West 4th Street Williamsport, PA 17701
NAME: _________________________________________________________________ (Please print, as you would like it to appear in print)
ADDRESS: _____________________________________________________________
________________________________________________________________________
PHONE (Home): _________________________________________________________
PHONE (Business): _______________________________________________________
E-MAIL ADDRESS: ______________________________________________________
MEMBERSHIP DONATION: ($25.00 Minimum) Paid:_____________
Options:
Checks Payable to: Lycoming County Celebrates the Arts Alliance_____ Cash______
Signature:_______________________________________________________________
________I would like to VOLUNTEER, please contact me about varied opportunities.
