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| Address1 |
| Address2 |
| City, State, Zip |
| Telephone |
Annual & Lifetime Memberships: Members in good standing may vote, receive free admission to the museum (when opened), and receive the quarterly newsletters.
| Category | Donation | Quantity | Total | List Name(s) |
| Annual Membership | $12.00 per person each year $25.00 per household each year |
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| Lifetime Membership | $225.00 for each person or $300.00 per household | |||
| Newsletter Subscription | $4.00 per year. Newsletter is free with regular memberships. | |||
| Donations |
For memorials please include "In Memory of John Doe" or "In Honor of John Doe" so that we may properly recognize them.
If there are more then two household members, please list everyone's name so we may prepare membership card for all members.
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I have included a check or money order in the amount of ____________.
Please make check or money orders payable to Perry Township Historical Society. Payments can be mailed to Perry Township Historical Society, P.O. Box 2402, Cridersville, OH 45806. Donations can also be made at our meetings.