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Upson Historical Society Membership Application

Mail, together with check, to:

Membership
Upson Historical Society
P.O. Box 363
Thomaston, Georgia 30286

Please make checks payable to Upson Historical Society.

Feel free to omit information you consider inappropriate.

Name:_____________________________________________________________
              (Last, First, Middle)
Home Address:_____________________________________________________________
                            (Street, City, County, State, Zip)
Business Address:_____________________________________________________________
                                    (Street, City, County, State, Zip)
Home Phone:   ( ____ ) ___________  Business Phone:   ( ____ ) ___________
Occupation:____________________________________
Place of Birth:_______________________________________________
                            (City, County, State, Zip)
Birthdate: _____/_____/_____
Maiden Name:__________________  Mother's Maiden Name:___________________


My chief interest in the Upson Historical Society is:

___ a. Obtaining more Upson history for our libraries and schools
___ b. Strengthening the museums and archives of Upson history
___ c. Finding ways to publish more Upson history
___ d. Preserving historical sites in the County
___ e. Attending historical lectures about the County/region
___ f. Meeting others interested in Upson's history
___ g. Learning more about the early settlers and families of Upson
___ h. Other:___________________________________________

I would be interested in serving on the following committees:
__ Membership
__ Nominating
__ Program
__ Research
__ Museum
__ Historic Sites
__ Publications

List other Historical Societies, Genealogical Societies or Patriotic Organizations of which you are now or have been a member:
_____________________________________________________________
_____________________________________________________________

Please enroll me as a:
___ Regular Member     $25.00 per person
___ Life Member     $200.00 per person

I would like to make tax-deductible contributions for the following:
$_______ Archives 6000 Fund 1
$_______ Archives Research Fund 2
$_______ Pettigrew-White-Stamps House Fund 3
$_______ African-American Museum Fund 4
$_______ Pictorial History Fund 5
$_______ Other/General Fund 6

________________________________
Signature

Please make checks payable to Upson Historical Society.



1   Archives 6000: This fund is for ordinary operating expenses (utilities, salaries, etc.) of the Thomaston Upson Archives. The Upson Historical Society has a commitment to raise $6,000 each year toward these expenses.

2   Archives Research: This fund is for money to be used by the archivist for otherwise unfunded materials (microfilm, books, etc.) or services.

3   Pettigrew-White-Stamps House: This fund is for operating expenses (utilities, maintainence, security, etc.) , as well as for any special expenses which would improve the usefulness of the Pettigrew-White-Stamps House for conveying history. Donations or loans of objects giving insight into the history of Upson County would also be appreciated.

4   African-American Museum: This fund is for operating expenses for the African-American Museum, as well as for any special expenses which would improve the usefulness of the Museum for conveying history. As this museum is still actively building its collection of objects giving insight into local (or more widespread) African-American history, donations or loans of such objects would also be greatly appreciated.

5   Pictorial History Fund: This fund is for covering the pre-publication costs of a book of pictures illustrating Upson County History.

6   Other/General Fund: This fund covers the basic expenses of the Society and provides money for special expenses (e.g., it was recently used to cover the printing costs for the reprinting of the Upson County History).

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