The Oyster Bay Historical Society

- Membership Application - 


        Your name: __________________________________

          Address: __________________________________

City, State & Zip: __________________________________

        Telephone: __________________________________



             Membership Category   Contribution    

             Individual            $  35.00     _________  
             Family                $  45.00     _________ 
             Contributing          $  75.00     _________
             Sponsor               $ 100.00     _________
             Sustaining            $ 250.00     _________
             Patron                $ 500.00     _________
             Benefactor            $1000.00+    _________              
             Business              $  75.00     _________              
             Business Sponsor      $ 100.00     _________              
             Business Friend       $ 300.00     _________              
             Business Patron       $ 500.00+    _________              
 
             Additional contribution*           _________              
 
    ENCLOSE your check drawn to    TOTAL**      _________ 
    Oyster Bay Historical Society
* Membership contributions in excess of $10 are tax-deductible. Many members select a category of membership -- say, "Contributing" -- and then contribute an additional amount -- for example, $20 more -- for a total contribution of $95.
** If your corporation will match this gift, please initial here. _________

Volunteers play an integral role in our Society. If you would like to join us as a Volunteer Member, please initial here. _________

Mail this form with your check to -- The Oyster Bay Historical Society
P.O. Box 297
Oyster Bay, NY 11771-0297
To print this form, select "Print" from the File menu. Go to our Membership page or to our Homepage.