Mt. Horeb Area Historical Society Membership Form
Mt. Horeb Area Historical Society
138 East Main St.
Mt. Horeb, WI 53572
To become a member, print out the application below, complete it and send with payment to the above address. We appreciate your interest!
Membership entitles you to our quarterly newletter and program notices
Contributions are tax-deductible to the extent allowed by law.
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MEMBERSHIP FORM
Name _________________________________________
Street _________________________________________
City, State ______________________________________
Zip/Postal Code _________________________________
(Optional)
Phone Number __________________________________
E-mail__________________________________________
Categories of Membership:
____ Individual $15.00
____ Household $25.00
____ Individual Lifetime $250.00
____ Benefactor $500.00
____ Building Fund Donation _________________________________________
Please make check or money order payable to Mt. Horeb Area Historical Society.
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You-Rah-Rah
Thank You For Joining
The Society!