The Stamford Historical Society

Give the Gift of Membership.

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Print by clicking on your browser's Print button at the top of the screen.

To contact us with your membership application, you can print and
mail the form, along with a check or credit card information to:
The Stamford Historical Society
1508 High Ridge Road
Stamford, Connecticut 06903

I would like to give the gift of membership to:

Name (Last):
Name (First):
Street Address1:
Street Address2:
City: State: Zip Code + 4:

Description of benefits

Enclosed is my gift of:

$25 - Senior/Student (under17/over 65)
$40 - Senior Couple
$35 - Individual
$50 - Family
Other:

Donor Information

Name (Last):
Name (First):
Telephone (include area code): Day Ext. / Evening
E-mail Address:
Street Address1:
Street Address2:
City: State: Zip Code + 4:

Membership Dues are tax deductible to the extent provided by law.

The Society is eligible for Corporate Matching Gift Programs. Kindly attach your company's form.

Check enclosed - please make check payable to The Stamford Historical Society
Charge my credit card account:	Visa
	Master Card

Credit Card # Expiration Date: Give the gift of membership!

Signature

Thank you!

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