Membership Application        New    Renewal

Student $5 

Name        
Address     
City             
 State               Zip
Phone         
Email        
   Bring or mail check to AKVHS -  224 East Seventh Avenue -
                              Tarentum PA 15084-1513

Individual $25
Family $35
Friend $75
Patron $150  
Sustaining $350
Trustee $500
Benefactor $1000

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