St. Francis Historical Society

Application for Membership

New Application

Renewal

Name

Address

City, State, Zip (please include commas)

Telephone

Email

Annual Dues

Individual $10.00

Family $12.00

Non-Profit/Small Business $5.00

Corporate $100.00

Members receive the Society newsletter by email. To also receive by regular mail, check

I would like to become involved in Society projects and activities.

We Appreciate Any Additional Donation You Can Give