Willsboro Heritage Society, Inc.
2006
eMembership Form
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Mailing Address:

Name:

Address:

City: , State: Postal Code:

Phone: Email:

Seasonal Address (If applicable):

Address:

City: , State: Postal Code:

Phone: Email:

You are at this address during the (Select one):  Winter Summer

(Aprox. Dates From/To: )      

Membership type (Choose one): Individual $20.00 Student $5.00 Family/Household $30.00 Business; $50.00 Non-Profit $35.00  

 Please make you check payable to; 
                                              The Willsboro Heritage Society, Inc.
                                                                P.O. Box 212
                                                     Willsboro, NY 12996-0212