Membership Application - Lowell Historical Society

Double Your Contribution!

Do you work for a Matching Gift Company? If so, your donation can be doubled. Check with your personnel office.
First Name: Last Name:
       
Membership Status: New Member    
  Renewal    
       
Address: Phone:
Address 2: Email:
City:    
State:    
Zip:    
       
Individual Membership Type: Friend $15 Corporate Membership Type: Corporate $100+
  Donor $25   Corporate $250+
  Sponsor $50    
  Associate $100   Amount:
  Patron $250  
       

Please print and mail this form to:

Lowell Historical Society
115 John Street
Fourth Floor
Lowell Massachusetts 01852

Please make check payable to "Lowell Historical Society"

Thank you for your support!