Membership Form

Please use this form to become a new member, renew your membership, order calendars or maps.

Name________________________________________________________________

Address_____________________________________________________________

       _____________________________________________________________

Email Address_____________________________Phone_____________________

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Dues $5 per person or $10 per family  __________________

Donation (always appreciated)         __________________

Calendars $8 plus $2 for mailing      __________________

Maps $3 plus $3 for mailing           __________________

TOTAL ..........................................  $_________________

Please mail to:

Hartland Historical Society
PO Box 297
Hartland, VT 05048