MEMBERSHIP FORM (PRINT and MAIL)

Student & Senior..$25   Single..$30   Family..$50   Patron..$100  Sponsor $250

Benefactor $500        Life Member..$1000 (available for those over 65 years of age)

Circle one of above categories:

Name:_______________________________________________________

Street:_________________________________________________________________

City:____________________________State:____    Zip:____  - ____  Country:_____

Charge to my:          MasterCard         Visa     [circle one]

Card Number:_________________          Exp.: Date:____/____/____

Signature:________________________________________

Or by check:  Pay to the order of:   The Beverly Historical Society  

Mail to:Beverly Historical Society, 117 Cabot St., Beverly, MA 01915

GIFT FAMILY MEMBERSHIP

Instead of giving that distant cousin another tie he won’t wear, why not give him a real family gift. The gift of generational connection. Many of our Balch members forget that those distant cousins they see only at the holidays are in many cases, also descendants of the "old planter" John Balch of Beverly, MA.

Why not surprise  them this year with a gift membership to the Balch House Associates. Maybe this will inspire a new family historian?

Yes! I want to give a Balch Family Membership to my relation listed below!

My relative's name is ______________________________________________

His/her mailing address is Street: ____________________________________

City ___________________________________ State ______ Zip ____ - ____

My name is _____________________________________________________

Membership Level [circle one]:

Student & Senior..$20   Single..$25   Family..$40   Patron..$100  Sponsor $250

Benefactor $500        Life Member..$1000 (available for those over 65 years of age)

PRINT and MAIL to:

Beverly Historical Society, 117 Cabot St. Beverly, MA, 01915, along with a check for the amount circled above, and we will send a card notifying your relative of your thoughtful gift.

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Questions or comments?  Call the Beverly Historical Society at (978) 922-1186 or email us at: info@beverlyhistory.org