MONSON HISTORICAL SOCIETY, INC., MEMBERSHIP FORM

Name ______________________________________________________
Address_____________________________________________________	Telephone	________
Town ______________________________________________________	State____	Zip______
E-mail Address (for newsletter)______________________________________________
Interested in becoming a board member? Yes No Intersted in archiving data/photos at a work party? Yes No

Please indicate a membership category & enclose a check made out to Monson Historical Society, Inc.
*Note: Membership renewal is May 1st of each year

__ Individual (under age 18) $5ºº __ Individual (age 18 & over) $10ºº

__ Family $20ºº __ Life Membership $500ºº __Corporate Membership $50ºº

Print This Form & Return to - Membership,One Green St., Suite One, Monson, MA 01057

Any information you provide to us will be kept in strict confidence
& would never be sold or shared with anyone