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  • HAL Membership Form

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    leandra922
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    This document is a membership form for the Historical Association of Lewiston. It requests the member's contact information and indicates the different membership levels and payment options, ranging from $20 for a student or senior membership to $150 for a lifetime membership. It also includes options to volunteer or set up automatic renewal of the membership each year.

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    This document is a membership form for the Historical Association of Lewiston. It requests the member's contact information and indicates the different membership levels and payment options, ranging from $20 for a student or senior membership to $150 for a lifetime membership. It also includes options to volunteer or set up automatic renewal of the membership each year.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    47 views1 page

    HAL Membership Form

    Uploaded by

    leandra922
    This document is a membership form for the Historical Association of Lewiston. It requests the member's contact information and indicates the different membership levels and payment options, ranging from $20 for a student or senior membership to $150 for a lifetime membership. It also includes options to volunteer or set up automatic renewal of the membership each year.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Historical Association of Lewiston

    Name: __________________________________________________________________
    Address: ________________________________________________________________
    City/Town: _______________________________________________________________
    State: _________________________

    Zip: ____________________________________

    Phone: __________________________________________________________________
    Email: __________________________________________________________________

    Please indicate Membership category:


    (

    Senior/Student Membership

    $20

    Individual Membership

    $25

    Family Membership

    $40

    Patron Membership

    $50

    Business Membership

    $100

    Lifetime Membership

    $150

    ) Please contact me about volunteer opportunities.

    ) Please charge my MasterCard or VISA:

    Card #: ________________________________________ Exp. Date: ________________


    3-digit Security Code (back of card) ___________________________________________
    (

    ) Please renew my membership automatically every June 1st.

    ( ) My check is enclosed, payable to:


    Historical Association of Lewiston
    P.O. Box 43
    Lewiston, NY 14092

    ***Thank you!***

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