Services

Memberships and
Contributions Form

Name:

Company/Organization:

Address:

City:

State:

Zip:

Phone:

Email:

I am interested in becoming a volunteer.

Membership

Yearly single membership $15

Annual Fund

Yearly family membership $25

Amount :

New Member

Renewal

Tribute Gift

Amount:

In honor or memory of:

Comments:

You can complete the form, submit it to us, and send a
check or money order separately, or print the form,
complete it, and mail it to us with a check or money order.

Checks should be made payable to:
Middlesex County Museum & Historical Society, Inc.
P. O. Box 121
Saluda, VA 23149-0121.

Memberships and contributions may also be
arranged by telephone. (804)758-3663
Contact us.

Thank you for your support!