Beverly Historical Society: Membership Form

Beverly Historical Society & Museum
Membership Form

Please complete and print this form then mail it,
along with your payment, to:

The Beverly Historical Society
117 Cabot Street
Beverly, MA 01915-5196

Choose one of the following Membership Branches*

* Membership is also available to The Balch House Associates.

Choose one of the following Membership Categories:

$25.00 Student
$25.00 Senior
$30.00 Individual
$50.00 Family

$100.00 Patron
$250.00 Sponsor
$500.00 Benefactor
$1,000.00 Lifetime (age 65+ only)

Please Select Payment Method:
If Check, Check #

Card # Exp

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
FAX
E-mail

NOTE: You cannot send this form electronically. You must print it out and mail it to us along with payment, to: The Beverly Historical Society, 117 Cabot St. Beverly, MA 01915.

Family Association Memberships available.

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