C & O Canal Association - Printable Association Membership Form

Name _____________________________________________________________
Address _____________________________________________________________
City, State and Zip _____________________________________________________________
Email _____________________________________________________________
Phone _____________________________________________________________
Name to appear on badge _____________________________________________________________
Name on 2nd badge _____________________________________________________________
Gift from _____________________________________________________________

Individual membership: $15
Family membership: $20
Patron membership: $25

Please make your check payable to the C&O Canal Association and mail it and this completed form to:

The C & O Canal Association
P.O. Box 366
Glen Echo, Maryland 20812-0366