Print Application

TREASURER, LEBANON HISTORICAL SOCIETY

P.O. BOX 18

LEBANON, NH 03766

Please enroll me as a member. I enclose one year’s dues (circle one)

$5.00 (Senior)

$10.00 (Active)

$15.00 (Sustaining);

$50.00 (Corporate)

$150.00 (Life membership)

NAME__________________________________________

STREET_________________________________________

CITY/TOWN_____________________________________

STATE_________________________ZIP______________

E-MAIL_________________________________________

(  ) This check also includes a donation.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this:
search previous next tag category expand menu location phone mail time cart zoom edit close