Presque Isle Historical Society Membership Application Form

Member Information
(Please Print)

Name______________________________________________________
Mailing
Address______________________________________________________

Phone # _____________________Home__________________________Work
E-Mail Address________________________________________________

_______ I would like to become an active member. Please notify me of meeting and activities
________Please list me as a supporting member, notify me only of special activities

Please check appropriate membership category. Membership is on an annual basis
______ $10.00 Individual
______ 5.00 (60 years and over; 18 years and younger)
______ 25.00 Family
______ 50.00 Business - Contact Name ________________
______ 200.00 Lifetime Membership for individual (one time payment)
Make checks payable to the Presque Isle Historical Society and mail to:

Presque Isle Historical Society
PO Box 285
Presque Isle, Maine 04769