| Name: | __________________________________________________ |
| Address: | __________________________________________________ |
| Town/City/Zip: | __________________________________________________ |
| Phone: | __________________________________________________ |
______I desire membership in LHS
______as a New Member or _________as a Renewal.
| ______ | $250 | Life Membership |
| ______ | $25 | Individual Membership |
| ______ | $15 | Senior (62+) Membership |
| ______ | $15 | Student Membership |
| ______ | $25 | Institutional Membership |
| ______ | $50 | Contributing Membership |
(All Memberships (except Life) are renewable annually.)
______ I wish to give a Special Gift. Please send me more informationon the Special Gift program of the Society.
I'm interested in:
______ Research
______ Reading
______ Publishing
______ Other: ________________________________________
Print,fill out and send this form to LHS/MA, 61 Seminary Ridge, Gettysburg,PA 17325
or by Email
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