Cemetery, Crematory, and Funeral Home Membership Application


Pennsylvania Cemetery, Cremation & Funeral Association
2200 Northampton Street, Easton, PA 18040
Phone: (610) 253-5222  --  Fax: (610) 253-3636  --  Email: DCM.Colleen@gmail.com

Cemeteries, Funeral Homes and Crematory Membership Application

SECTION A: COMPANY INFORMATION

Company Name:  

Address:

 

Mailing Address (If different from above):

 

Representative:

Title:

Phone:           Fax:  

Email:  

Products or services you offer:

 

SECTION B: INFORMATION

Total number of people on payroll: (Full Time), (Part Time)

Total number of years you have been involved in death care services:  

Total number of years you have owned, operated or managed this company:  

I/ we hereby apply for admission as members of the Pennsylvania Cemetery Cremation and Funeral Association. Membership dues are as published and may change with action approved by the board of directors with due notice to members. If this application is approved, I/we agree to be governed by the bylaws of the organization as they are now or may be hereafter amended. I/We acknowledge that by including our e-mail address, PCCFA is granted the right to send you association information, which may include supplier member’s information, in an electronic form. You will have the right to notify us to opt out of information from supplier members.

Leave this empty:

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Signature Certificate
Document name: Cemetery, Crematory, and Funeral Home Membership Application
lock iconUnique Document ID: 99c5e8cf8068e445b52f08b0d720dfe0b0d481bd
Timestamp Audit
October 13, 2022 11:26 am ESTCemetery, Crematory, and Funeral Home Membership Application Uploaded by PCCFA Online - megan.warner@webcemeteries.com IP 73.214.215.96
November 2, 2022 1:20 pm ESTPCCFA Exec Team - PCCFA.exec.team@gmail.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:20 pm ESTCharles Schwalm - cschwalm@letuminc.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:20 pm ESTDagny Neel Fitzpatrick - dagny@jeffersonmemorial.biz added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:20 pm ESTErnie Petersen - southsidestray@mac.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:22 pm ESTPCCFA Exec Team - PCCFA.exec.team@gmail.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:22 pm ESTCharles Schwalm - cschwalm@letuminc.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:22 pm ESTDagny Neel Fitzpatrick - dagny@jeffersonmemorial.biz added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:22 pm ESTErnie Petersen - southsidestray@mac.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96
November 2, 2022 1:22 pm ESTMegan Warner - megan.warner@webcemeteries.com added by PCCFA Online - megan.warner@webcemeteries.com as a CC'd Recipient Ip: 73.214.215.96