Hinckley Historical Society Membership Application

 

Name(s): _____________________________________________________________________________

Address: _____________________________________________________________________________

City/State Zip _________________________________________________________________________

Daytime phone: ______________________________________________________________________

E-Mail address: _______________________________________________________________________

Type of membership application:

_____ New     

_____ Renewal

 

Please select a membership category:

_____$15 Individual Yearly Membership (benefits for one adult)

_____$20 Household Yearly Membership (benefits for two adults and

               children to age 18 in one household and grandchildren to age 18)

_____$15 Gift  Membership Member (benefits for one adult)

_____$20 Giift  Membership Member (two adults and children to age 18 in household)

Payment enclosed is my check for $_______ payable to the Hinckley Historical Society (mail only).

Send to: Hinckley Historical Society

               PO Box 486

               Hinckley, IL 60520

_____Please send information about volunteer opportunities

_____Please withhold my/our name from mailing list exchanges

_____Please limit e-mails to information about my/our membership

_____Number in household

Membership is yearly and begins the 1st of January, regardless of date paid. Membership includes a Hinckley History quarterly publication, Membership card, and free admission to quarterly meeting with informational programs. Membership dues may qualify for a tax deduction.

Questions? Call 815-286-7270, or e-mail hinckleyhistoricalsociety@yahoo.com

To give a gift of membership, please also complete the information below:

Gift recipient's name(s)_______________________________________________________________________

Gift recipient's address________________________________________________________________________

Gift recipient's city/state/zip___________________________________________________________________

Gift recipient's daytime phone _________________________________________________________________

Gift recipient's e-mail address__________________________________________________________________

First renewal notice will be sent to the gift giver. Unless otherwise specified, gift membership will be mailed to gift recipient.

If interested in joining any of the following committees below check them accordingly.

_____ Historical    ____ Membership

_____ Programs                 ____ Public Relations

_____ Ways and Means

Thank you for your support of the Hinckley Historical Society.

Mar. 2011