Member
Here is the form to fill out if you want to become a member:
Members, please pay your dues by January by filling out the form below and sending it in. Thank you!
Membership Application:
Portage County Historical Society
6549 N. Chestnut St
Ravenna Ohio 44266
or
E-mail: [email protected]
Date ____________ New ____ Renewal ___ _
Name(s) _________________________________________ _
Address. _________________________________________ _ City ____________________ State ___ Zip ________________ _
Phone/e-mail. _______________________________________ _
Level of Membership: Individual $15 ____ Senior S8 ____ Family $20 ____
Sustaining S30 ___ _ Contributing $1OO ____ Life $300
Portage History Gold $I000.00 _______
Donation in Memory of __________________________ $ _________
Donation ______________________ TOTAL _________
Members, please pay your dues by January by filling out the form below and sending it in. Thank you!
Membership Application:
Portage County Historical Society
6549 N. Chestnut St
Ravenna Ohio 44266
or
E-mail: [email protected]
Date ____________ New ____ Renewal ___ _
Name(s) _________________________________________ _
Address. _________________________________________ _ City ____________________ State ___ Zip ________________ _
Phone/e-mail. _______________________________________ _
Level of Membership: Individual $15 ____ Senior S8 ____ Family $20 ____
Sustaining S30 ___ _ Contributing $1OO ____ Life $300
Portage History Gold $I000.00 _______
Donation in Memory of __________________________ $ _________
Donation ______________________ TOTAL _________