Membership Form

Name: ________________________________________________

Street: ________________________________________________

City/State: ________________________________ Zip: _________

Phone: ________________________________________________

Email: _________________________________________________

New Member _____      Renewal _____

Please add $5.00 to any membership outside the United States.

Please return this printed form with your check payable to the Historical Society of Cheshire County to the address below. Membership fees are tax deductible to the extent allowable by law. Please include all names for family memberships.

Historical Society of Cheshire County
P.O. Box 803, 246 Main Street
Keene, New Hampshire  03431