HARALSON COUNTY HISTORICAL SOCIETY


MEMBERSHIP APPLICATION

"Membership is open to any person
interested in the history of Haralson County
and the preservation of that history."

World Wide Web: http://hchistory.com
Telephone: 770-646-3369
Fax: 770-646-1103


PERSONAL INFORMATION:

Name _______________________________________________________________

Address _______________________________________________________________

City _________________ State _________________ Zip ______________

E-mail _______________________________________________________________

Telephone (Home) ________________________ (Work) ________________________

Fax (Home) ________________________ (Work) ________________________


MEMBERSHIP FEES (please check one of the following choices and enclose payment):
Individual ($15/year) __ Founding Associate ($500 in one payment) __
Family ($20/year) __ Founder Membership ($1000 in one payment) __
Lifetime ($200 in one payment) __

MAIL TO:              

Haralson County Historical Society
P.O. Box 585
Buchanan, GA 30113


Last updated 2005 May 20