West Hants Historical Society

Is this a New or Renewing Membership

NewRenewal

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number

Please enter a valid phone number.

Yearly Membership Type:*

Individual Membership ($20)Family Membership ($30)Institution Membership ($50)

Would you like to volunteer?

Payment Method*

Credit CardE-TransferCash/Cheque

My Products

Individual MembershipYearly Individual Membership

$20.00CAD for each year

Family MembershipYearly Family Membership

$30.00CAD for each year

Institution MembershipYearly Business, Institution, Organization Membership

$50.00CAD for each year

Credit Card

How did you hear about us?

Why are you interested in joining our association?

Do you have any special skills or interests you would like to contribute as a member?

Any other comments or questions?

Declaration:

I certify that all information provided in this application is true and accurate to the best of my knowledge. I understand that membership approval is at the discretion of the association and may be subject to review.

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Date

Membership Application

Payment Information:

Credit Card

Additional Information: