Name:______________________________________________________________________________________   Home Phone:________________________________
 
Address:___________________________________________________________________________________________  Cell Phone:___________________________
 
City:____________________________________________________________________________________ State:___________ Zip Code:________________________
 
Email Address:_____________________________________________________________________________________________________________________________
 
Please check one choice below, and circle "New" or "Renewal":   
 
______Individual Annual Membership = $10                                 New  or  Renewal
 
______Individual Lifetime Membership = $100                             Today's Date:___________________________________________________
 
Would you like to become a docent/greeter, bake cookies, research historical subjects, provide craft items for the gift shop, donate items for a silent auction, or donate skills e.g. cleaning, painting,woodworking, computer skills, write articles, write grant applications, give a presentation at the meeting?  Get involved!  Let us know what you would like to see or do.
 
Permanent committees are Fund Raising, Membership, Publicity, Historic Sites, Museum Displays, Collections, Cataloging and Signage.
 
Would you be interested in being a volunteer?    ______ Yes            ______ No
 
Please list your areas of historic interest: _________________________________________________
 
_____________________________________________________________________________________
Benton County Historical Society is a 501c(3) organization and all donations are tax deductible.