Membership Application
Please complete the following to helps us maintain accurate records for your membership to the Coalition for Community Living (CCL).  
As a reminder, membership fees are as follows:
$55 for an individual or professional
$110 for an organization (includes one lodge;  an additional $10/extra lodge)
$15 for a student
All membership fees should be made payable to The Coalition For Community Living and mailed to:

Brendan Bayer (Treasurer)
4038 Riva Ridge Road  
Harrisburg, PA 17112
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Email *
Do you need to update any information related to your membership (contact information, number of lodges?) *
IF YOU ANSWERED "YES" ABOVE, CLICK "NEXT" BELOW.

IF YOU ANSWERED "NO" ABOVE, I/we owe dues of:
(Student - $15.00 a year)
(Individual - $55.00 a year)
(Organization - $110.00 a year including 1st Lodge, addition $10.00 per Lodge above 1)

THIS IS YOUR INVOICE - PLEASE INDICATE AMOUNT OWED BELOW
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