Shelby County Historical Society Membership Form

Shelby County Historical Society Membership Form
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Areas of special interest (i.e. Genealogy, Civil War, Volunteering
Individual membership is $25 annnually and family membership is $40 annually. Membership entitles members to the newsletter and admission to all programs.
Membership Type*

NewRenewal
Membership
prevnext( X )
The Old Sexton, Mr. Moesser$25.00
New membership or renewal

Edwin Hubble$50.00
New family membership or renewal

Thomas Baxter$75.00

Julia Tevis$100.00

Abraham Rothchild$250.00

Daisy Saffel$500.00

Whitney M. Young, Jr.$1,000.00

Squire Boone$2,000.00

Total $0.00
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