Membership in the Long Island Chapter
of the
United States Lighthouse Society

Please print this form, fill it out, and submit it with your dues to the address at the bottom of the form. If paying by PayPal, send the required information via e-mail, in addition to your PayPal payment.

New Membership_____     Renewal_____                                                     (Rev. 2/7/2026)

Name
Street Address
Town, State, Zip Code
Telephone (Optional)
E-mail (Optional)

The membership year is October 1 - September 30. Chapter members must be US Lighthouse Society members.

I would like to join the USLHS and the Long Island Chapter: ____ Individual $35     ____Family $50    _____ Senior $30

Any additional donation: $_________          

Would you be interested in volunteering?       If so, please note any special skills or experience below: _____________________________________________________________________________________________

(If you are already a US Lighthouse Society member, Chapter dues are: Individual $15. Family $20. Senior $10.)

Please send a check, made out to "Long Island Chapter, USLHS," to:

Membership Department
Long Island Chapter, USLHS
PO Box 21
Greenport, NY 11944