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Seymour Historical Society

P.O Box 433 Seymour, Conn. 06483 

2013 Membership Form

 

 

NAME: ­­­­­­­­­­­­­­­­­­­__________________________________      E-MAIL ______________________________

 

ADDRESS: _______________________________      TOWN/ZIP CODE _____________________

 

MEMBERSHIP TYPE: _________________________

 

$25 Annual Individual         $15 Annual Senior (Over age 62)           $10 Annual Junior (Under age 18)

$45 Annual Family               $150 Life Membership (Individual)       $200 Life Membership (Business)

 

ADDITIONAL DONATION:  _________   (Those who give at least $30 ABOVE the cost of  membership dues total will receive a Seymour Historical Society tote bag OR a T-shirt. Please indicate your choice:)

 

Tote Bag: ________        T-Shirt: ______   (Circle color/size)   Red    Black      S      M        L         XL   
 

______________________________________________________________________________________

 

I would like to do volunteer work for the Seymour Historical Society:

 

______ DOCENT: Serve as a guide when museum is open to public or during programs.

 

______ INTERIOR MUSEUM ASSISTANCE: Light cleaning, such as vacuuming and dusting.

 

______ PROGRAMS: Help choose guest speakers and distribute promotional materials before programs.

 

______ CURATOR ASSISTANCE: Help organize and set up exhibits.

 

______FUNDRAISING: Help plan events that raise money for the Society.

 

______RENOVATION: Help organize work by contractors and oversee their work.

 

______ YARD WORK: Help maintain our property by doing weeding, leaf pick-up, etc.

 

______ EDUCATIONAL OUTREACH: Teach students about Seymour history.

 

______ I have other skills that could help the Seymour Historical Society. They are:


 

The Society mails out flyers announcing upcoming programs. Do you wish to receive these?

 

_____ Yes, please send flyers and other announcements through the U.S. mail.

 

_____ Instead of mailings, please send program information to the email address listed on this page.

 

_____ No, please take my name off of all mailing lists and do not send me emails.

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Seymour Historical Society Seymour Historical Society,
Mar 7, 2013, 8:27 PM
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Seymour Historical Society Seymour Historical Society,
Mar 7, 2013, 8:29 PM