Become a Member - PFLAG Greater Harrisburg

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PFLAG Greater Harrisburg Membership Form

please complete this form to help us update our records

Annual Membership is from 10.01 thru 9.30 the following year.

Current Date

Enter the current date

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Newsletter(Required)

I would like to receive the PFLAG Chapter Newsletter via email:

Please select a Membership Fee/Donation options (payment process at the end of this form):

$35 Annual Membership Fee (supports community outreach, educational materials, etc)

$25, $50, $75, $100 or other donation to our PFLAG Greater Harrisburg Lippert/Sizemore Scholarship Fund

Did you know you can also designate your United Way donation to go directly to PFLAG Central PA? Simply contact the United Way and let them know!

How to Make Your Payment:

ONLINE VIA A CREDIT CARD:

submit this form below (click 'submit') and the confirmation page that pops up will have a payment link to click on!

CHECKS:

Please make checks payable to 'PFLAG of Central PA' and mail to:

PFLAG of Central PA

c/o St. Paul's UCC

626 Williams Grove Rd. Mechanicsburg, PA 17055-7510
(PFLAG is not a religious or political organization)