Annual Membership
Indian Hill Historical Society
Preferred Title
Please Select
Mr. & Mrs.
Mr.
Ms.
Mrs.
Dr. & Mrs.
Dr. & Mr.
Dr. & Dr.
Mr. & Mr.
Mrs. & Mrs.
None
e.g., Mr., Mrs., Ms. Mr. & Mrs.,
Preferred Title
e.g., Mr., Mrs., Ms. Mr. & Mrs., Dr. & Mrs., Mr. & Mr. etc.
Name
*
First Name
Last Name
Business Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Membership Levels - Please select one:
*
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Individual
$
60.00
for each
year
Unlimited
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Recurring payments
Family
$
90.00
for each
year
Unlimited
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Recurring payments
Patron
$
250.00
for each
year
Unlimited
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Recurring payments
Business
$
350.00
for each
year
Unlimited
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Recurring payments
Cornerstone
$
600.00
for each
year
Unlimited
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Recurring payments
Bell Ringer
$
1,200.00
for each
year
Unlimited
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Recurring payments
1873 Club
$
1,873.00
for each
year
Unlimited
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Recurring payments
Credit Card
Submit
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