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Monson Historical Society, Inc.
Membership Form

Name ______________________________________________________ Telephone ___________________________________

Address ________________________________________________________________________________________________

Town __________________________________________  State ____________________________  Zip ___________________

Email Address (for newsletter only) ___________________________________________________________________________

Please indicate a membership category and include a check made out to the
"Monson Historical Society"
One Green Street, Suite One
Monson, MA  01057

_____ Individual $10.00          _____ Family $20.00                     _____ Life Membership $250.00


Membership renewal is May 1st of each year