Sand Lake Historical Society

Join/Renew Your Membership

Name _________________________________________________________________
Address ______________________________________________________________
Phone ___________________ E-mail _______________________________________

$3 per Student (13-22) __ $10 per Individual __ $15 per Family __
$100 per Lifetime (Individual) __ $150 per Lifetime (Family – two persons) __

Total enclosed: $__________

Receive newsletter electronically? Yes ___ No ___ |

Interests: ____________________________________________________________

Print this page and mail, along with check payable to Sand Lake Historical Society, to:

Sand Lake Historical Society
PO Box 492
West Sand Lake, NY 12196

or download this form in .PDF format