PITTSTOWN HISTORICAL SOCIETY

 

Membership application/renewal form
(print & mail to the address below)

 

 

 

 

 

 

 

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$10  Individual

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$5 Senior (65 & older)

 

 

 

 

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$25 Supporter

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$50 Benefactor

 

 

 

 

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$15 Business

 

 

 

 

 

 

 

 

 

 

Total (enclose check for this amount)

 

 

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I would like to volunteer my time


  Name:

 

  Address:

 

  City, State, Zip:

 

  Telephone Number:

 

  E-mail address:

 

 

  

Make checks payable to:    

Pittstown Historical Society

P.O. Box 252, Valley Falls, NY 12185

 

 

 

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