The Cheshire Historical Society
The Hitchcock=Phillips House
43 Church Drive Cheshire, Connecticut 06410 USA Telephone: 203-272-2574
MEMBERSHIP FORM FOR THE
CHESHIRE HISTORICAL SOCIETY - BECOME A MEMBER TODAY!
ANNUAL MEMBERSHIP DUES
PLEASE PRINT THIS FORM, COMPLETE & MAIL TO:
|The Cheshire Historical
P.O. Box 281
Cheshire, CT 06410
More about MEMBERSHIP AT THE CHESHIRE HISTORICAL SOCIETY
Telephone Number: (_____) _________________
Mailing Address: ________________________________________
Town: ______________________________ Zip Code: _____________
E-Mail: _________________________@_____________ Would you like to receive our newsletter by e-mail? YES / NO
Enclosed dues of $ _____________ for membership in
Your check payable to: "The Cheshire Historical Society, Inc."
Classification of Dues:
___ Individual $20.00
___ Family $25.00
___ Business / Professional $40.00
___ Supporting $40.00
___ Senior Citizen $10.00
___ Life $200.00
We wish to keep dues to a minimal amount. However, dues alone do not cover the society's operating costs. We hvae added a line for any additional contribution you may care to make.
___ Additional Contribution $__________
All contributions are tax deductible to the extent by law.
Events and meetings are held at the Hitchcock-Phillips House, 43 Church Drive
Cheshire, CT unless noted otherwise.
Call 203-272-2574 or e-mail for more information.
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