Membership Application

Note: The Highland Township Historical Society offers two (2) membership options:

Family - Dues are $15.00 per calendar year, payable each January

Life - A one-time contribution of $100.00

Members in both categories are entitled to receive each issue of the Society's Signpost newsletter. While membership is not required to participate in Society meetings and events, the funds raised through membership dues, contributions and other sources help support our efforts to collect, preserve and make available to others the rich history of our community.

Dues and contributions are tax deductible as a charitable/educational donation.

NAME: ________________________________________________________________

ADDRESS: ________________________________________________________________

________________________________________________________________

Please include your full 9 digit ZipCode if known

EMAIL: ________________________________________________________________

Please circle the type of membership desired:

Family @ $15.00/year Life @ $100.00

Kindly make your check payable to "Highland Township Historical Society" and send with this completed

form to the address above. If this is a Gift Membership for a person or family residing at another mailing

address, please write "Gift" and the complete name and address of the recipient below.