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DelChester Public Works Association Membership Form
2024 Membership
676 Copeland School Road
West Chester, PA 19380
admin@delchesterpublicworks.org
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* Indicates required question
Municipality/Company Name
*
Your answer
Main Contact Person
First & Last Name
*
Your answer
Email (required)
*
Your answer
Title
Your answer
Secondary Email (preferred)
Your answer
Second Member Name
Your answer
Second Member Title
Your answer
Mailing Address
*
Your answer
Phone Number
Your answer
Membership Base Fee
*
Municipality $50
Vendor $100 (includes 1 representative)
# of Members for Municipality: $20 per person
(use number, do not type word)
Your answer
# of Members for Vendor: $50 per additional representative
(use number, do not type word)
Your answer
Mail Check
and
copy of Invoice Form to our new address:
DelChester Public Works Association
676 Copeland School Road
West Chester, PA 19380
Total Check Amount:
*
Your answer
Questions/Comments. Please include any other email addresses that you would like to add to our email list.
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