Colchester Historical Society "new member" application form

Please copy & forward this form Bob Furst for processing to assure your membership is effective immediately...you will be hearing from him shortly... see Officers & Directors  for address...

"Thank you for your interest in joining our Historical Society".......Coralie Magoon, President.

Current date:

Please provide the following contact information:

First Name
Last Name
Street Address
City
State/Province
Zip/Postal Code
Home Phone
FAX

E-mail

Please indicate any interests you may have in serving on the committees below:

Library          Program        Membership   Schoolhouse Museum    
Building         Landscaping    Phone        Audit           
Book Inventory   Web Site       Refreshment  Nominating

Dues Options:

Annual Membership    $5.00
 Lifetime Membership  $100.00

  Exit                                                                                                                                                 
Copyright © 2003 [Colchester Historical Society]. All rights reserved.
Revised: 11/13/08