The Guilford Historical Society of New York 

                                                          

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         Membership Application

Name:_____________________________________

Address:___________________________________

City:_______________________________________

State:______________________________________

Zip Code:___________________________________

Phone incl area code:_________________________

Email Address:_______________________________

Your email address allows us to send you the GHS meeting minutes and

Our newsletter.

Please make sure you let us know if there are any changes, if

And when they occur.

Donation Amount_____________________________

Should you decide to donate and extra amount to the society, you can

select which fund to go to. Such as Building Fund, Cemetery Fund,

School House Fund, etc.

Otherwise, we will place the donation in the overall fund to

Cover our operating expenses.

Donation for:_________________________________

The following categories for membership: Please circle your

Preference.

Single member, one year                                                         $20.00

Family, one year                                                                      $25.00

Single member, lifetime                                                        $300.00

                   Please make check(s) payable to                    

                        The Guildford Historical Society

            And mail(with the above information) to

                      The Guilford Historical Society

                        PO Box 201, Guilford, NY 13780