MEMBERSHIP DRIVE NOW IN PROGRESS! WASHINGTON COUNTY & CH AMBULANCE & CHAIR SERVICE WASHINGTON NORTHWEST 75 Braden St., Washington, PA 15301 Call (724) 225-8050 or 1-800-244-0165 Call Membership Line For Brochure (724) 225-1332 2018-2019 MEMBERSHIP APPLICATION I Circle Location: Washington » Northwest |Make check/money I AMBULANCE & Married Couple. . . . . $55 Renewal-_New- I order payable to: Individual..$35 Date $35 Phone No. CHAIR SERVICEmi$65 Family6wp, Boro, City. (CHECK TYPE)xiresDember 15, 2019I ..$65 Endlosed Payment 75 Braden Street aon, PA15301 Name: Address: City: Phone Number: Twp.: Zip: