CHANGE OF ADDRESS FORM

Please complete this form and submit electronically.
The Highlands Historical Society. Inc. | 524 N. 4th Street | Highlands, NC 28741-0670
*  = Required entry
NEW INFORMATION
*  Name(s)
    Title (Mr., Mrs., Ms., Dr.)
*  (1) Primary Address
        City, State, Zip Code
   (2) Secondary Address
        City, State, Zip Code
        Dates at this address
    Country (if not USA)
*  Email Address (or write "None")
    Phone (work/home)
    Fax
 
OLD INFORMATION
*  Name(s)
    Title (Mr., Mrs., Ms., Dr.)
*  (1) Primary Address
        City, State, Zip Code
   (2) Secondary Address
        City, State, Zip Code
        Dates at this address
    Country (if not USA)
*  Email Address (or write "None")
    Phone (work/home)
    Fax
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Last updated on October 6, 2008