HAMILTON COUNTY HISTORICAL SOCIETY
MEMBERSHIP APPLICATION FORM

NAME:________________________________________

ADDRESS:_______________________________________________

CITY:______________________

STATE____ZIP____
HOME PHONE:___________WORK PHONE__________

E-MAIL ADDRESS__________________________

WEB PAGE(pertaining to Hamilton County Indiana)_____________________________________________
MAY WE PUBLISH THE INFORMATION ABOVE: YES____NO____

TYPE OF MEMBERSHIP, PLEASE CHECK ONE AND FORWARD THE CORRECT AMOUNT WITH THIS APPLICATION

NEW PRICES EFFECTIVE JANUARY 1, 2002

____$10.00-STUDENT AND SENIORS(65+)
____$15.00-REGULAR
____$25.00-FAMILY
____$50.00 SUSTAINING(INDIVIDUAL OR FAMILY
____$200.00 LIFE (ONE PAYMENT)

INTERESTED IN VOLUNTEERING(Please select one area you are willing to assist in)

____PUBLICATIONS(Writing/Art/Publishing
____HOST/HOSTESS
____SPEAKERS BUREAU
____SPECIAL PROJECTS
____OFFICE ASSISTANCE
____MEMBERSHIP/FUND RAISING

Please mail this application with a check and/or money order (no credit cards accepted) to:

HAMILTON COUNTY HISTORICAL SOCIETY
P.O. BOX 397
NOBLESVILLE, INDIANA 46061
317-770-0775