Online Membership Form

Welcome to the Cape Canaveral Lighthouse Foundation.

Annual membership levels are:

Head Lighthouse Keeper …………….. $100
Lighthouse Keeper (family) …………… $50
Lighthouse Keeper (individual) ……… $35
Student Membership ……………………. $15

Sustaining membership levels are:
Head Lighthouse Keeper ………………. $90
Lighthouse Keeper (family) …………… $40
Lighthouse Keeper (individual) ……… $30

We also have lifetime membership levels:

Life Membership (2 family member) … $1,500
Life Membership (single) ………………… $1,000

Please enter your contact information below. For renewing members, this form helps us keep our records current.

New MemberRenewing Member
First Name: (required)

Last Name: (required)

Address - line 1: (required)

Address- line 2:

City: (required)

State: (required)

Zip Code: (required)

eMail Address: (required)

Phone Number: (required)

Cell Phone Number:

I have read and accept the Terms and Conditions of the
Cape Canaveral Lighthouse Foundation.

Are you interested in becoming a volunteer?
YesNo

Pressing 'Send' will pass the information included in the form to the Foundation membership chairperson. The next page will help you pay the membership dues through PayPal.

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