GREATER DOVER HISTORICAL SOCIETY, INC.

2009 APPLICATION FOR MEMBERSHIP/RENEWAL

(please print clearly)

____ New

____ Renewal

Member Number: _____________                             Date:  ________________________ 

Name(s) of each member:  __________________________________________________ 

________________________________________________________________________

 Address: ________________________________________________________________

 City, State, Zip ___________________________________________________________

 Phone: __________________________________________________________________

 E-Mail Address: _______________________________Amount Paid: ________________

 Individual - over 18 years old                       $10.00                 

Student                                                         $  5.00

Family - includes children under 18                $25.00                 

Business                                                      $50.00
Make all checks payable:  GDHS, Inc.

Mail to:  Lori Koch, Secretary/Treasurer, 77 South Main Street, Dover PA 17315

E-mail address:  doverhistory@gdhspa.org

Any comments, ideas or suggestions?  Let us know below!

MEMBERSHIP DUES ARE FOR January 1, 2009 to December 31, 2009.

Dues that are remitted before September 1 will be applied to present year.   Dues remitted after September 1 will be for the upcoming year. Unless individual is a member for present year, one cannot volunteer for projects until January 1 of the following year.

The official registration and financial information of the Greater Dover Historical Society, Inc. may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania,   800-732-0999.   Registration does not imply endorsement.