Membership Application

Please fill out the following fields to become a member of the Friends of the Cemetery. Payment is available on the next page to pay online, or you may print out the membership form and send payment through the mail.

*First Name:

*Last Name:

*Address:

*City:

*State:

*Zip Code:

Phone:

*Email:

*Security Key:

Mailing Address:
775 East Washington St.
Medina, OH 44256

Membership levels are as follows:

Senior - $10
Individual - $15
Family - $25
Contributing - $50
Supporting - $100
Heritage - $250
Lifetime - $500
Corporate - $1,000