Deposit Historical Society
Membership Form
Deposit Historical Society, 145 Second St., Deposit, NY 13754
You are cordially invited to join The Deposit Historical Society, either as an Annual or Life Member.
Name(s) ___________________________________________________________________________
Street Address ______________________________________________________________________
City, State, Zip Code ________________________________________________________________
E-mail _____________________________________________________________________________
Telephone __________________________________________________________________________
Membership Category, per individual |
Cost of membership |
No. of memberships |
Total Cost |
Regular Membership, annual rate |
$10.00 |
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Student Membership, annual rate |
$5.00 |
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Senior Citizen Membership, annual rate |
$5.00 |
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Lifetime Membership, one-time payment |
$50.00 |
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We welcome additional donations to support our goals (optional) |
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Order Total |
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Checks/Money Orders should be made payable to: Deposit Historical Society
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Mail this completed form with your payment/donation to:
Pat OĠDonnell
415 Silver Lake Spur
Hancock, NY 13783
Attn: Membership
(607) 467-4778
_____ Please check here if you are interested in lending a hand in working on any one of the many events or participating in one of the committees listed in our newsletter. If you have a particular interest, please feel free to list it below