Piper Aviation Museum Membership Application

Personal Membership
-$20.00
Family Membership
-$30.00
Personal w/ Engraved Brick
-$80.00
Family w/ Engraved Brick
-$100.00
Life Membership
-$300.00
Engraved Brick
-$75.00

Members Receive: In addition, Life Members also receive:

If you have any questions please feel free to contact the museum at
570-748-8283.

 

First Name
Last Name
Address
City
State
Zip Code
Phone Number
Amount for Membership
Type of Payment
Cash
Check
Credit Card Type
Credit Card Number
Expiration Date

Brick Inscription: (3 lines, 14 characters per line)