New HCHS Membership Form

Membership Application Form

PO Box 127, Lake Linden MI 49945 Phone 906-296-4121 Email:info@houghtonhistory.org
Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
Membership Levels. Please check one.*
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Individual Annual (Email)$25.00

Individual Annual (Postal Mail)$30.00

Individual Lifetime (Email)$300.00

Individual Lifetime (Postal Mail)$300.00

Family Annual (Email)$40.00

Family Annual (Postal Mail)$45.00

Business / Corporate (Annual)$50.00

Total $0.00
Should be Empty:

Membership Application Form