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DVRC Membership Application

Read the details about the Delaware Valley Raptor Center's Membership Program here.

Print and mail this page including a check or money order to:

Delaware Valley Raptor Center
416 Cummins Rd.
Milford, PA  18337

Make checks payable to DVRC.
If you need further information call (570) 296-6025 or email

Name______________________________________    Telephone __________________

Address _________________________________________________________________

City _____________________________________  State _____  Zip ________________

Email Address ___________________________________________________________
(Your email address is strictly for DVRC's use in communicating with members. It will not be sold or given out.)

images/checkbox.gif (904 bytes)  Gift for ________________________    Age (if child) _______  From ____________________

Card signed   images/checkbox.gif (904 bytes)  Happy Birthday    images/checkbox.gif (904 bytes)  Merry Christmas   images/checkbox.gif (904 bytes)  Other  ___________________

Red checkbox gifPlease check applicable boxes:

checkbox gif(106 bytes)  New Member   OR    checkbox gif(106 bytes)  Renewing Member

checkbox gif(106 bytes) Student  $25.00     checkbox gif(106 bytes) Individual   $30.00    checkbox gif(106 bytes) Family  $35.00  

checkbox gif(106 bytes) Supporting   $50.00    checkbox gif(106 bytes) Sponsor $100 - $249   checkbox gif(106 bytes) Guarantor $250 - $499 

checkbox gif(106 bytes) Sustaining  $500 - $1000   checkbox gif(106 bytes) Patron $1000 & Over

We thank you for your support!

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