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MEDAL OF HONOR HISTORICAL SOCIETY OF THE UNITED STATES

Donation/Membership Application/Renewal Form

 
 
YES!  I support the Medal of Honor Historical Society of the United States and would like receive Above and Beyond, its quarterly newsletter.  
Please enter my membership application in the category checked below.  I have enclosed a check or money order in the amount indicated and
I am pleased to accept my canceled check as my receipt.    (The MoHHSUS is a 501(c)(3) organization)
 
 
  $20  [  ]  General                                                                        $50 [  ] Organizational
 
 
         [   ] Medal of Honor Recipient - Honorary member
                    exempt from dues with the same rights as that
                    of a General member.
 
 
 
Donation:  $                          For:  _____________________________________
  

If making a donation in memory of an individual, please give us their name and family's address so we can inform the family of your gift.  

If you wish your gift to remain anonymous, please check here [   ].

I wish to make a donation in memory of: 
(Name of Individual & address of  family) 

                                                  

                                                 

                                                 

Total Amount Enclosed

$                    ___                           


Name:                                                                                 


Phone:                                            


Address:

(City, State, Zip)                                              ___                                       ____                      _________

 

E-Mail: _______________________________________________________________________

 

The majority of our communications to include sending of our electronic newsletter will be via
e-mail.  We do not make membership information, addresses or e-mail addresses available to other organizations. 

 

 

 

Have you researched or written a paper or book on a specific person, battle or war?  

 

 

______________________________________________________________________________

(This is not mandatory, it just lets us know your area of expertise in case we receive an inquiry related to your line of research that you may be able to assist with.)

 

On some printers, the Google menu on the left prevents this page from printing properly. 
You can either copy and paste this page into Word or use the membership application below which is in .pdf format.
 
Please make your check payable to the MOHHSUS and mail it along with the application to our Treasurer at: 
MOHHSUS
c/o David N. Lotz
2541 Hickory Ridge Drive
Plano TX 75093-6191
 
 

Attachments (1)

  • MOHHSUSMembershipApp.pdf - on Aug 18, 2009 3:30 PM by Medal of Honor Historical Society of the United States (version 3 / earlier versions)
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