Join the Museum Family!

Name

Address

Address 2

City

State

Zip

Use address above as Billing Address?

Yes

Billing Address

Billing Address 2

City

State

Zip

Monthly Dues are only $10 per month! Please choose a payment Method.

Check

Card

Cardholder Name

Card Number

CCV

Submit

Please Print this form and mail with check to:

Bloomsburg Children's Museum

Attn: Membership Coordinator

301 Sunnydale Lane

Bloomsburg PA, 19103

You will recieve your welcome packet in 2 to 3 weeks.

Thank you for Supporting the Museum!