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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