Virginia Historical Society

Membership Application Form

Please print this form and mail to the Virginia Historical Society.

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Name (as you would like it to appear)

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Address

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City                                                                        State              Zip

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Telephone

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Email

Select a membership level:

Check box Student (full-time) $32    Check box Teacher $32    Check box Senior Individual (over 65) $42    Check box Individual $45

Check box Military Individual $32      Check box Individual plus one $55      Check box Senior Couple (over 65) $55

Check box Family $62                         Check box Military Family $62              Check box Benefactor $250

Battle Abbey Council:

Check box Associate $500    Check box Fellow $1,000    Check box Senior Fellow $2,500   


Check box I do not intend to make use of the facilities for my private party or special event. Therefore, all of my contribution is considered tax deductible.

Check box I want to help the Virginia Historical Society. Enclosed is my additional gift to the Annual Fund, which is fully tax deductible. $line

Total enclosed $line

Please mail this form with your check to:

Membership Office
P.O. Box 7311
Richmond, VA 23221

A financial statement is available upon request from the Virginia Office of Consumer Affairs in the Department of Agriculture and Consumer Services.

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