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MEMBERSHIP APPLICATION

KENMORE HISTORICAL SOCIETY

Name______________________________________
Address____________________________________
City_______________________________________
State___________________  Zip________________
Phone_____________________ Age_____

MEMBERSHIP FEES

□ Individual  ____________      $20.00
     □ Family   ______________     $25.00
     □ Senior (age 60+) _______     $10.00
     □ Senior husband & wife __       $15.00
     □ Student (in school) _____       $10.00
     □ Life _________________      $100.00

BUSINESS & CORPORATE

□ Silver________________    $50.00
     □ Gold ________________    $100.00
     □ Life _________________    $500.00

 
Amount Enclosed: _________________

Make check payable to:
KENMORE HISTORICAL SOCIETY

Send to:
Kenmore Historical Society
P.O. Box 3707
Akron, OH. 44314