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Benton County Historical Society
2021 MEMBERSHIP FORM
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.
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