TAMPICO AREA HISTORICAL SOCIETY
Please check one: Donation________ New membership ________ Renewal________
Suggested donation of $3.00 per transcription
DATE: _____________
Name: __________________________________________________________
Address: _______________________________________________________
Telephone: ( ) _________________
Email:____________________________
Amount Enclosed: $___________
Membership Fee Schedule (effective May 1, 2005)
Annual Dues:
Single = $10.00
Family = $15.00
Business = $50.00
Sponsor= $10.00
Patron = $25.00
Business=$50.00
Life-time memberships for a one time fee of $50.00 per person will be available to anyone age 55 or over.
Family Surnames:____________________________________________
What is your interest in the Historical Society?_________________________________________________________
_________________________________________________________
Please make checks payable to: Tampico Area Historical Society
Please remit to:
Tampico Area Historical Society
P. O. Box154
Tampico, Il 61283
Membership is from May 1 - April 30