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Print the Form, Fill it
Out and Mail to
MEMBERSHIP
Cowlitz County Historical Society
405 Allen Street
Kelso, WA 98626
(360) 577-3119
Members receive the Cowlitz Historical Quarterly
and/or the historical society Newsletter and invitations to special museum events, as well
as a 10% discount on most items purchased in the Museum Store
and are eligible for a discounted membership in the Washington State Historical
Society.
YES, I(we) would
like to support the historical society by purchasing a membership. Enclosed is
$__________________, for the membership category indicated below. (Please
check one.)
| ___ Newsletter Subscription |
$20.00 |
|
___ Cowlitz Historical Quarterly Subscription |
$30.00 |
| ___ Individual Membership |
$35.00 |
| ___ Family Membership |
$40.00 |
| ___ Contributing Membership |
$75.00 |
| ___ Benefactor/Business Membership |
$150.00 to $499.00 |
| ___ Sponsor Membership |
$500.00 to $999.00 |
| ___ Life Membership |
$1,500.00 and above |
Your Name____________________________________
Address_______________________________________
_____________________________________________
Phone_________________________________________
E-mail ______________________________________
Date__________________________________________
Is this a new membership________ or a renewal________ ?
If this membership is a gift for someone else,
please fill in the information below:
Member's Name________________________________
Address_______________________________________
_______________________________________
Phone________________________________________
When it is time to renew this gift membership, would you like
the renewal notice sent to: _______Myself _______My Friend
IN ADDITION, I(we) would also like to contribute to
the historical society's long-term financial stability. Enclosed is $__________________ as
a donation to the Endowment Fund.
□ check enclosed
□ visa/mastercard
visa/mc # ___________________________ exp. ________
signature
_________________________________________
Or please make checks payable to the
Cowlitz County Historical Society.
In appreciation for your support, a membership card
will be
mailed soon.
Thank You!
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