Dorset Vermont Historical Society

Membership Application

Please print this page and include with your donation.


Name:
Street Address:
Town, State, Zip:
Phone:
Email:


Dues

Regular: $35 per year ( Jan 1 - Dec 31 )
Supporter: $50 per year
Sustaining: $100 per year
Patron: $250 and above per year
Benefactor: $500 per year
Major Donor: $ _________


Checks should be made payable to:
      Dorset Historical Society
      P.O. Box 52
      Dorset, VT 05251

Your dues and contributions are tax deductible.


Dorset Historical Society
P.O. Box 52 · Route 30 at Kent Hill Road
Dorset, VT 05251 USA · 802-867-0331 · Fax 802-867-0412
E-mail: dorsethist@verizon.net