Membership Application Form

Membership Application

I/we would like to become members of the Pine-Strawberry Archeological and Historical Society. Enclosed is payment for the following type of membership:

q Individual or family ($20 annually)
q Business or corporation ($35 annually)
q Sustaining ($50 annually)
q Life ($200 one-time payment)
q Patron ($1,000 one-time payment)

Volunteer service: is usually scheduled for a specific time on a specific day each week, or a volunteer may sign up to be "on call when needed." If you'd like more information on volunteering, please indicate below.

q I am interested in serving as a Museum Docent. I am available (days) _________________ AM PM
q I would like to serve on a committee for a specific event
Please name the event ___________________
q I am interested in serving on the Pine-Strawberry
Archeological and Historical Society Board of
Directors.

Please make your check payable to and mail to:

PSAHS
P.O. Box 564
Pine, AZ 85544

Name ____________________________________________
Mailing Address ____________________________________
Street Address _____________________________________
City _____________________ State ________ Zip ________
Home or business phone number ( __ ) ____________________
E-mail address_______________ Fax Number______________