MEMBERSHIP FORM
Name
____________________________________________
Address
____________________________________________
____________________________________________
City
____________________ State _______ Zip _________
Telephone Home
___________________________________
Telephone Work
___________________________________
E-mail address
___________________________________
Membership Levels
$25 Individual
_________________
$40 Family/Dual
_________________
$100 Supporting
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$150 Patron
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$250 Benefactor
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Additional Contribution
_________________
Total Enclosed
_________________
Please make check payable to: The South End Historical Society.
Contributions are tax-deductible.
I am interested in:
Preservation
Newsletter
Fundraising
House Tour Committee
Spring Ball
House Tour Sitting
Membership
Programs/Events
Please mail membership application to:
The South End Historical Society
532 Massachusetts Avenue
Boston, Massachusetts 02118
For more information, please call 617-536-4445.
