The Stamford Historical Society

Give the Gift of Membership

You can fill out the information below from your keyboard. To contact us with your membership application, you my 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:

 

Signature

Thank you!