Moultonborough Historical Society, INC
Organized in 1958 : Incorporated - September 26, 1994 501(c) (3) Non-Profit Corporation
P.O. Box 659
Moultonborough : NH 03254
Renewal or New Membership 2015
Please check the 1 Year Membership for 2015 you wish, for the amount of money you have enclosed.
 
____ Individual Membership $20.00
____ SILVER Individual One Year Membership $75.00
____ GOLD Individual One Year Membership $100.00
Please PRINT and complete the form below and mail in with your payment. Thank you!
Last Name
First Member First Name   First Member MI  
Mailing Address

Second Member First Name

Second Member MI  
Town
Comments or list names of other family members � use back of form for more room  
State
Zip Code
Email Address  
Mail to:
Fran Vincent
c/o MHS Membership Chairman Make Checks Payable to:  Moultonborough Historical Society
P.O. Box 1148
Center Harbor, NH 03226    

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