2013 MEMBERSHIP APPLICATION

To become a member of the Brownsville Historical Society, please print this page, complete the form below and mail it along with your check or money order for membership fee to:

BROWNSVILLE HISTORIC SOCIETY
BOX 24
BROWNSVILLE, PA 15417
ATTN: MEMBERSHIP

FIRST/LAST NAME:______________________________________________________________________

ADDRESS:______________________________________________________________________________

CITY:________________________________________________STATE:________ZIP:________________

PHONE NUMBER:_______________________________________

EMAIL ADDRESS:________________________________________________________________________

MY OCCUPATION IS:_____________________________________________________________________

I am a NEW MEMBER  _____   RENEWING A MEMBERSHIP  _____  giving a GIFT MEMBERSHIP  _____

YEARLY MEMBERSHIP TYPE:
          (Make checks payable to BROWNSVILLE HISTORICAL SOCIETY)
          Annual Individual Membership ($10.00)   _____
          Annual Family Membership     ($15.00)   _____

I would like to volunteer as a TOUR GUIDE:       YES_____   NO_____

I am willing to give time to the Society:              YES_____   NO_____

I am interested in volunteering for one of the following committees:

          _____Archives-Curatorical          _____Membership          _____By-Laws          _____Nominating
          _____Castle                             _____Special Events       _____Gift Shop         _____Publications
          _____Special Events                   _____Maintenance        _____Finance            _____Program
          _____Landscaping-Garden