Make your own free website on Tripod.com
Home | About Us | Contact Us | Membership | Publications | The Sixtowns | Town of Adams | Town of Ellisburg | Town of Henderson | Town of Lorraine | Town of Rodman | Town of Worth | Gallou & Stony Islands | Index | Links

Historical Association of South Jefferson

Membership

Help us preserve the local history of the Sixtown area of Southern Jefferson County. Become a member. Your membership includes 6 newsletters per year, each filled with interesting articles and stories from the past.

Membership Application
 
Date ________________________________________________
Name _______________________________________________
Address _____________________________________________
City ________________________________________________
 
State ___________________Zip ____________________
 
Phone (optional) ____________________________________
Email (optional) _____________________________________
 
Circle Catagory:              Amount:
Senior Citizen------------------$8.
 
Student----------------------------$8.
 
Individual------------------------$12.
 
Family----------------------------$25.
 
Business-------------------------$25.
 
Sponsor--------------------------$35.
 
Patron----------------------------$50.
 
Life (one time payment)---$150.
 
Benefactor--------------------$200.+
 
Print form and send with check or money order to:
 
Historical Association of South Jefferson
29 E. Church St.
Adams, NY 13605 
 

Copyright 2003-2013 by the Historical Association of South Jefferson. All rights reserved.