Membership Application

Name _____________________________________________________________________________

Address ___________________________________________________________________________

City __________________________________________  State __________  Zip ________________

Phone ______________________________________________

Email _______________________________________________

Select Level of Membership:
□ Curator's Club $250
 □ Heritage Club $150
 □ Founder's Club $100

Tell Us Your Areas of Interest __________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Method of Payment:     □  Check        □ Visa       □ Mastercard

My Check for $ _______________ is enclosed.

Please make checks payable to Maumee Valley Historical Society (MVHS)


For Credit Card Payment, please include the following information:

Cardholder's Name: __________________________________________________________

Card Number: ______________________________________________________________

Expiration Date: ___________________________  3-Digit Security Code: ______________

 

Maumee Valley Historical Society Membership Application
 The heritage of the Maumee Valley and its surrounding communities is preserved through membership in the Society. If you are interested in becoming a part of this collegial organization, print and fill out this page and return to: Membership Committee, 1031 River Road, Maumee OH 43537.
If using a credit card, fax to 419-893-3108.

Close this page and visit the
"MVHS Mission"
link for more information
on membership.

□ Legacy Club $50
 □  General $35
 □  Senior/Student $25