Membership Form

 

Thank you for your  support!   Please print this page, fill out the membership form below, and mail along with your check made payable to ATHS.

 

 

Name___________________________________________________________

 

Address_________________________________________________________

 

City______________________________   State________   Zipcode ____________

 

Phone________________________________

 

E-Mail Address (Optional)_________________________________

(emails are used strictly to communicate with members regarding ATHS events, and will not be sold or given to other organizations)

 

Membership Choices:

 

_____   Student  $10.00                                      _____Individual    $20.00

 

_____   Family    $25.00                                     _____Individual Lifetime    $300.00

 

_____   Corporate Annual  $100.00                  _____Family Lifetime             $375.00

                                                                                           includes children up to age 18

 

 

Optional Tax deductible donation:

 

_____Daily Mortgage Payment  for Trexler Grain Mill   $40.00

 

I would like to dedicate this donation in memory of:

 

___________________________________________________________

(name of person(s), event,  and date of memory,

Example; John and Jane Doe, 25th wedding anniversary July 5, 2007)

 

Please make your check payable to Albany Township Historical Society and mail with this form to:

Albany Township Historical Society,

P O Box 95

Kempton, PA  19529

 

Shortly after receipt of payment, you will begin receiving quarterly news letters (including any back-issues for the currently year)