MEMBERSHIP APPLICATION

I/WE WISH TO JOIN THE APPLETON HISTORICAL SOCIETY

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NAME(S)

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ADDRESS

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CITY AND ZIP CODE

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PHONE #             E-MAIL ADDRESS

____    $15 INDIVIDUAL         ____   $25 FAMILY

 ____    $50 BUSINESS    $______ EXTRA DONATION

DATE: ___________________

Membership reqires no special commitments or obligations and is per calendar year. Thanks for Your support.
PLEASE RETURN WITH PAYMENT TO:

Appleton Historical Society

 2631 N. MEADE STREET, SUITE 101, APPLETON, WI 54911

QUESTIONS?  CALL 991-0405 OR SEE WEBSITE AT www.focol.org/appletonhistory