Brunswick Area Historical Society

MEMBERSHIP FORM

Mail to: Brunswick Area Historical Society
4613 Laurel Road, P.O. Box 714
Brunswick, OH 44212

Name: _____________________________________________

Address: ____________________________________________

City, State, Zip: _____________________________________

Telephone: __________________________________________

Email address: _______________________________________

Membership Fees:
$ 10.00 Over 65 or Student
$ 15.00 Individual under 65
$ 20.00 Family

Patron:
$ 25.00 Silver
$ 50.00 Golden
$ 75.00 Platinum
$100.00 and over Diamond

Questions, suggestions, donations please call (330)220-8352
Email address:
BrunswickHistory@aol.com