Annual Membership Dues

(January-December; please check desired membership)


______Active Individual ($10)______Active Family ($15)______Youth (under 18) ($2)

______Contributing ($15 Plus) ______Group/Organization ($25) ______Business/Professional ($100)

______Business-ad in newsletter and all events ($150) ______Life Membership ($1,000)

Joinnow

Date_______________New______________Renewal_______________

Name______________________________________________________

Address____________________________________________________

City______________________________State_________Zip_________

Home Phone__________________Work Phone____________________

Fax_________________________E-mail_________________________



Mail to:

Historical Society of Carnegie

1 West Main Street, Carnegie, PA 15106-0826



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Created by T Cook ... November 30, 2000