Membership Application

We invite you to become a member and support Warren County Historical Society. Simply print this web page, fill out the form and mail to the address at the bottom of the page.

o New Membership
o Renewal

Name______________________________________________________

Firm_______________________________________________________

Street_____________________________________________________

Town/City_________________________________________________

State_______________Zip____________________________________

Phone_____________________________________________________

E-mail_____________________________________________________

Please circle your level of enrollment:

Life Member..............$500

Patron........................$300

Sustaining...................$125

Contributing.................$50

Family..........................$40

Individual......................$20

Please check any of the following that apply:

o Please send me complimentary information

o I am interested in becoming a society volunteer. Please contact me.

o My employer matches gifts to cultural institutions. Enclosed is my Matching Gifts Form.

Corporate Membership

Please circle your level of enrollment:

Corporate Contributor........................$100+

Corporate Donor................................$200+

Corporate Benefactor..........................$500+

Annual memberships are deductible to the extent allowable by law.

Please make checks payable to Warren County Historical Society at the address below.

Warren County Historical Society // 195 Sunnyside Rd. // Queensbury, NY 12804
(518) 743-0734 //