Membership

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AMELIA COUNTY HISTORICAL SOCIETY

                                                         Membership Application and/or renewal form

Name _________________________________________________
            Please type or print.

Address _______________________________________________

______________________________________________________
             City State Zip Code

Phone Number __________________________________________

Email Address ___________________________________________
􀀀 Check here if you prefer that your newsletter or correspondence be emailed.

{   } New Member                                                            

{   } Renewal
􀀀

Individual ($20) Family ($25)

*Membership year begins _________ Month __________ Year

 

Make check or money order payable to:  Amelia County Historical Society

mailing address:

Amelia County Historical Society
P. O. Box 113
Amelia, VA 23002


*Membership includes quarterly newsletter