Colchester Historical Society new member application form

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

"Thank you for your interest in joining our Historical Society"
Clinton Reichard, President.

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

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These pages are published and maintained by the Colchester Historical Society
For problems or questions regarding this Web site contact  Bob Furst
Last updated: 06/27/2012