MEMBERSHIP FORM

Please complete this form and submit electronically.
The Highlands Historical Society. Inc. | 524 N. 4th Street | Highlands, NC 28741-0670
New Member| Renewal
*  = Required entry
*  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
    Subjects of Interest
    Where did you hear about HHS?

* HHS ANNUAL DUES

$35 - Individual

$50 - Family

$100 - Sustainer

$250 - Business

$500 - Promoter

$1,000 - Preserver

$2,500 - Protector

$5,000 - Highlander

Additional contribution $ 

*  Total $ (DUES + contribution)
*  Paid by credit card below or check in the mail
 
The Highlands Historical Society is a (501)(C)(3) organization.
Using this secure Web form, you may pay by Credit Card or Debit Card through PayPal.
Click the Donate button and then either sign up or log in on the PayPal page.
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Last updated on October 31, 2008