_____ New Member
_____ Renewal NAME: ____________________________________________________________________ Mailing address: _____________________________________________________________ City ______________________________________ State: ____________ ZIP ____________ HOME PHONE AND/OR CELL: _________________________________________ EMAIL ADDRESS: _________________________________________ (please print) Please note the change in this year's form. ADD $10 to the membership fee for Individual or Family if you are requesting that the newsletter be mailed to you. Memberships run from January to the end of December. Annual Membership Fee: (check one, please) INDIVIDUAL
____ $20 per year … includes admission to club-sponsored events and monthly newsletter subscription for person listed.
____ $30 if newsletter is mailed.
____ $30 per year … includes admission to club-sponsored events and monthly newsletter subscription for all family members residing at same physical address.
____ $40 if newsletter is mailed.
____ $50 per year … includes same benefits as individual and family memberships but, in addition, Business Sponsors will be listed in the newsletter and website for as long as their membership is kept current. No extra charge for mailing newsletter for Business Sponsorships.
_____Mail my newsletter. Please print the name of your business below so we know how to print it in the newsletter.
Other tax deductible donation amount $__________________.
Please make checks payable to:
Catron County Historical Society
and mail to:
PO Box 263
Quemado, NM 87829
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