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Goffstown Historical Society
Membership Application

Complete this form, print it out and mail it with your payment to:
        Goffstown Historical Society
        P.O. Box 284
        Goffstown, N.H. 03045

Name: ________________________________

Address: ______________________________

City: _________________________________

State and ZIP Code: _____________________

Optional: Phone Number: ___________ Optional: E-mail address: ___________

Membership Categories (Annual Dues)
Individual $12 / year  
Contributing Sponsor $50 / year  
Lifetime Membership $120  
 Cash, checks, and money orders accepted.    //   Sorry, we cannot process credit cards. 

Enclosed is my check for __________ dues and ___________ additional gift

Thank You! Your support is appreciated!

I would like to volunteer for (check or circle any which apply):

[Note: if you wish to volunteer, please provide a telephone number above]