Join Lancaster EMS

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What Membership is Right for You?+

Online Payment Processing

Signing up for a Lancaster EMS membership online via this form requires payment via PayPal. PayPal supports a large number of credit cards, including Visa, MasterCard, American Express, Discover, and several other payment services.

2026 Membership Form

Please fill out the form below to start your membership sign-up process. If you have any other questions, please contact us. If you'd like to pay by mail, please download a copy of our membership flyer.

Which year would you like to sign up for?*:
Membership Type*:
Cost of Membership:
Would you like to add an additional donation?:
Total Cost:

First Name of person to be covered*:
Last Name of person to be covered*:

Phone # of person to be covered*:
E-mail of person to be covered*:
Address Line 1 of person to be covered*:
Address Line 2 (if needed):
City*:
State*:
Zip Code*: