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.

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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
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