Membership form

Date:
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Name:
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Address:

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Phone:

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Email: _________________________

checkbox I wish to view newsletter electronically only.

Winter address if different:

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What months? underline

Please enroll me for:
checkbox 1 year at $10 per person per year
checkbox number of years at $10 per year = $underline
checkbox life membership $100 per person
Enclosed also is a donation of $underline for the museum. (optional)
I am interested in:
checkbox serving as a museum volunteer in summer
checkbox serving on a committee.
My area of interest is:
checkbox baking for sales, events
checkbox helping with yard sales, other fund raising events

Please return this form and any enclosures to:

Milbridge Historical Society
83 Main Street (Route 1)
Post Office Box 194
Milbridge, Maine 04658