Please enter my membership in the Lycoming County SPCA for
the year __________,
to demonstrate my commitment to the aid of homeless & abused animals.
Membership Levels and Rates:
Please enclose check made out to:
Lycoming County SPCA
You will be contacted for your brick order.
Name: __________________________________________________________
Address: _________________________________________________________
City: ____________________________________________________________
State: ________________________________________
Zip: __________________________________________
Home Phone: __________________________________________________
Please print out this application and mail it with your check to:
Lycoming County SPCA
2805 Reach Road
Williamsport, PA 17701
570-322-4646