WHS  MEMBERSHIP APPLICATION

 

 The following will be used for your directory listing:

Name(s) ____________________________________

Address _____________________________________

City, State____________________________________

Zip + 4 _____________________________________

Phone (_____)_______________________________

The following for office use only:

Email:_______________________________________

Total amount enclosed:_________   Ck. #_________

  • Send information on:

____    Gift Membership 

          ____    Memorial /Tribute

____   Rental guidelines

  •            I/We waive all benefits. ("Star" level only)

I/We would like to support the Wauwatosa Historical Society  at this level:

                 Individual  $15 - 74

                 Senior Individual (62 and over)  $10 - 74

                 Household $25 - 74

                 Senior Household (62 and over)   $15 - 74

                Organization $35 & above

                Business $50 & above

                Firefly Star $75 - 149

                 Silver Star $150 - 499

                Gold Star $500 - 999

                Platinum Star $1000 & above

Mail this completed form & your check payable to:

Wauwatosa Historical Society

7406 Hillcrest Dr.

 Wauwatosa, Wi 53213

 

Questions? Please call: 414-774-TOSA (414-774-8672)  

Website: www.wauwatosahistoricalsociety.org

Email: staff@wauwatosahistoricalsociety.org Fax: 414-774-3064