2017 Membership Application 

 

Membership expires 9-30-17

 

 

 
 
 
 
 
 

 
 
 
 
 
Yes, I want to become/remain a member of PFLAG of Central Pa!

 

 

 Yearly Membership

—$35 

 

 An additional contribution to help support PFLAG is included. 

Amount  $ ___________________ 

 
 
 

Here are my concerns/suggestions for program topics: 
 
 __________________________________________________________________________________ 
 
__________________________________________________________________________________ 

 
 
I would like to receive via email: 

 PFLAG of Central Pa. Newsletter   

 

 

 

   

 PFLAG National Newsletter

 

 

Name _____________________________________________________________________________ 
 
Address ___________________________________________________________________________ 
 
City _____________________________________ State _______________ ZIP __________________ 
 
Date ____________________ Phone __________________ E-mail ____________________________ 
 
 

Make checks payable to “PFLAG of Central PA” and mail to: 

 

 

PFLAG of Central PA 

 

P O BOX 812 
Mechanicsburg, PA 17055-8812 

 

  

 
 

PFLAG is not a religious or political organization. 

www.pflagcentralpa.org 

Central Pennsylvania Chapter