Orange County Historical Society, Inc.
130 Caroline Street
Orange, VA 22960-1533

Date____________   For Year____________

[   ]   Membership Application

[   ]   Renewal

Membership Categories

[   ]   Annual Membership - $12.50

[   ]   Annual Sustaining - $50.00

[   ]   Annual Patron - $100.00 to $300.00

[   ]   Life Membership - $300.00

Contributions

[   ]   Contributions   ___________________

 

Name _________________________________

Address________________________________

______________________________________

Email Address:___________________________

Phone Number:___________________________

Society membership runs from January through December

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