Conway Historical Society
Membership Application

"Become A Member"  and Join the fun at CHS

Membership Benefits include
Four issues per year of our newsletter
Special admittance to the Eastman Lord House Museum and future exhibits
in and around the Mt. Washington Valley.
Updates to website / online & e-mail - support

Support one of New Hampshire's best Societies    "CHS"

Thank you for your submission. We will be contacting you soon with your membership or donation confirmation.

   Single Membership   (US$20.00)

Aditional Contribution             Amount ________________
This is a gift             Note: ____________________________________
I am renewing my membership

Personal Information:

Name (First & Last) ____________________________________

Billing Address: ____________________________________
Street Address: ____________________________________

City:__________________  State:______  Zip: ______

Country:  ______

Telephone:_________________   E-Mail: _________________

Comments____________________________________________________________________
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Mail Payments To:
Conway Historical Society
P.O. Box 1949
Conway NH. 03818