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                                            Yorkville Historical Society
                    A member of The Confederation of SC Local Historical Societies
                                and The Palmetto Trust for Historic Preservation

                                                                    Membership

                Name: _____________________________

                Address: ___________________________
                              ___________________________
                Phone: ________________ 

                e-mail address? _______________

                Amount Paid: $_________
                Date: _________

Type of Membership: ___ $ 5.00 Student Member             ___ $ 8.00 Single Member 
    (check one)           ___ $ 15.00 Family/Household          ___ $ 30.00 Sponsor 

_______________________________________________________________________________________
    Mail to:     Yorkville Historical Society
                     P.O. Box 1122
                     York, SC 29745

Or Give this completed form to a Board Member:

        Anne Allison         Jan Ramsey         Helen Jackson             Pete Bethea 
        Scott Hollis           Betty Sawyer      Cindy Jonas                 Penny Lemberger
        Jackie Hardy        Charles Boyd       Peggy Enright              Marguerite Neary 
        Lisa Robards        Peggy Palmer       Russell Propst             Grace Ebersold Ulbricht
        Eddie Lee 
_______________________________________________________________________________________
To Print this Form Click your Browser's Print Icon or Select File>Print.