Membership & Donation Form
Please make checks payable to
Belmont Historical Society
c/o Jane McLetchie, Treasurer
180 Dutile Road
Belmont, NH 03220
Belmont Historical Society invites your involvement in any of the following ways.
State
Zip
Fax #
(tax deductible)
Membership dues cover January 1, 2008 through January 1, 2009
Thank you for your support!
On your BROWSER click file, print to print this form, and mail to address above with check payable to the "Belmont HIstorical Society".
Name
Address
City
Telephone #
Email Address
Annual Membership Family $15.00
Annual Membership (1 person) $10.00
Monetary Donation of
Other Donation