Membership in the Middletown Historical Society is open
to anyone and everyone who has an interest in the
historic preservation of our town.
At the present time, our web hosting service does not
have the capability of accepting forms on-line. Please
fill out and print the following form and send the form,
along with your check in the appropriate amount made out
to the Middletown Historical Society Inc. to: The
Middletown Historical Society Inc. PO Box 4196,
Middletown, RI 02842-0496.
|
|
MEMBERSHIP FORM
|
|
Required Information: |
| Last Name |
| First Name |
| Address Line 1 |
| Address Line 2 |
| City |
| State |
| Zip Code |
|
Optional Information: |
| Phone |
| Fax |
| E-mail |
TYPE OF MEMBERSHIP
|
| |
check
appropriate box |
| New |
|
| Renewal |
|
LEVEL OF MEMBERSHIP
|
| 15.00 Individual |
|
| 20.00 Family |
|
| 35.00 Contributor |
|
| 45.00 Institutional or Business |
|
| 250.00 Lifetime |
|
|
I would be interested in volunteering for the following
(Check as many as you wish)
|
| Archivist Financial Member Recruiting Special Events
|
|
| Board of Directors Grant Applications Photographer
Videographer |
|
| Building Maintenance Historian Researcher Web
Development |
|
| Computers Legal Contributor Recruiting Writing |
|
| Docent Programs Librarian Social Programs |
|
| Educational Programs Media Relations Speaker Programs
|
|
| Other:
|
|