MCHS  Membership Application Form

This form can be printed and brought or mailed to the Historical Society Office

 Individual Annual Membership

 $10 Annual Donation

 Family Annual Membership

 $15 Annual Donation

 Lifetime Membership

 $100 Donation

 Patron Membership

 $2,500 Donation

 Museum Restoration

 $50 small paver recognition

 Museum Restoration

 $500 medium paver recognition

 Museum Restoration

 $1,000 large paver recognition

Extended Membership Categories Open to Life and Patron Members

 Contributing Membership

 $50 Annual Donation

 Sustaining Membership

 $100 Annual Donation

 Corporate Sponsor

 $200 Annual Donation

 Corporate Patron

 $1,000 Annual Donation

 Name: ______________________________________________________________

 Address: ____________________________________________________________

 City, State and zip code: _______________________________________________

 e-mail: ___________________________________    Phone Nr: ___________________________

  MAKE CHECK PAYABLE TO:

  Monroe County Historical Society (MCHS)

  MAIL YOU CHECK AND APPLICATION TO:

  Monroe County Historical Society (MCHS)

  P.O. Box 538, Woodsfield, Ohio   43793-0538

  IF YOU HAVE QUESTIONS OR NEED HELP:

  Please Call the MCHS office at (740) 472-1933

  or  e-mail  or  write us at the above address