MEMBERSHIP
FORM
AUGLAIZE COUNTY HISTORICAL SOCIETY
Address________________________________________________
City, State, Zip___________________________________________
Telephone Number_______________________________________
E-mail Address___________________________________________
Would you like to receive information about upcoming historical society activities by e-mail? _____
Would you like to receive your newsletter by e-mail? _____
What areas of history interest you? __________________________________________________
What kind of programming (lectures, exhibits, trips, etc.) interests you? ____________________
_______________________________________________________________________________
Would you like to volunteer with the historical society? If so, in what ways?
(tours, children’s programs, archives, property maintenance, other)
________________________________________________________________________________
Any other comments or suggestions? __________________________________________________
LEVELS OF SUPPORT
____$10 Scout (for students)
____$25 Explorer (basic adult membership, including newsletter and other mailings)
____$50 Discoverer (reduced admission for events and trips + 10% discount on merchandise
of $25 or more purchased directly from the historical society)
____ $100 Pioneer (benefits as above)
____ $250 Settler (benefits as above + special recognition in society newsletter and programs)
____ $500 Homesteader (benefits as above + special recognition)
____ $1000 Founder (benefits as above + copies of current publications)
Founders are considered full sponsors of all ACHS activities and programs.
Please make your check payable to the Auglaize County Historical Society, and mail it to ACHS, 223 South Main Street, St. Marys, Ohio 45885.
Thank
you for supporting the
Auglaize County Historical Society!