Cumberland County Historical Society Membership Request
(Just print, fill out, and send with your check to the address below.)
Please circle one....NEW Membership....RENEWAL Membership
(All information will be kept confidential.)
Name ________________________________________________________
Street Address ________________________________________________________
City _________________________________________________________
State ________________
Zip Code ________________ Phone Number (with area code) (_____)__________________
E-mail _________________________________________________________
Membership Categories
(Check the membership of your choice)
| Individual ------------- | $35.00 ----- | $_______ |
| . | ||
| Family ------------- | $40.00 ----- | $_______ |
| . | ||
| Supporter ---------- | $50.00 ----- | $_______ |
| . | ||
| Patron ------------- | $150.00 ----- | $_______ |
| . | ||
| Business ----------- | $250.00 ----- | $_______ |
| . | ||
| Corporate ---------- | $500.00 ----- | $_______ |
| . | ||
| James Hamilton ----- | $500.00 ----- | $_______ |
| . | ||
| Heritage Circle ----- | $1000.00 ---- | $_______ |
Make check payable to "CCHS" and mail to:
CCHS Membership
P.O. Box 626
Carlisle, PA 17013