Community Historical Society Historical Society Membership
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WE INVITE YOU TO BECOME A MEMBER OF THE NILES HISTORICAL SOCIETY

Please indicate the type of membership


Life Benefactor

$500.00

Corporate Life Membership @

200.00

Individual Life Member @

100.00

Patron *

50.00

Institutional *

25.00

Contributor *

15.00

Individual *

8.00

Individual Senior Citizen,          Age 62 *

7.00

Student *

2.00

* Denotes annual membership
@ Denotes One Time Contribution


Name:

Address:

Telephone: (       )


Fiscal Year: January 1 - December 31 All dues are TAX DEDUCTIBLE

Mail this Completed Form and Payment to:



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