Highlands Historical Society-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 check in the mail
or by credit card below.

The Highlands Historical Society is a (501)(C)(3) organization.

Using this secure Web form, you may pay by Credit Card, Debit Card, or PayPal.

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Last updated on August 2, 2010