To apply for membership, please print this page, fill out this application form and mail, along with your $25.00 per person dues, to this address:



Membership
Escambia County Historical Society
P.O. Box 276
Brewton, AL 36427


Name(s) _______________________________________Date_____________  List all names on this sheet if more than one membership is desired

Address _________________________________________________________

City ____________________________ State _______ Zip _______________

Telephone Number(s) __________________________________________

Email ____________________________________________________________

Special Interests _______________________________________________

___________________________________________________________________

I would like to be involved with ________________________________

___________________________________________________________________



Dues                    ________________  
$25.00/person for individuals; $50.00 for businesses 
(includes a business card sized advertisement in 11 issues of the newsletter); $250.00 lifetime membership.

Donation             ________________

Total enclosed  ________________

Note: If you have questions about  Lifetime or Business Membership, please contact the society.

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This page last modified on Sunday, February 10, 2008