Membership Application
Name _____________________________________________________________________________
Address ___________________________________________________________________________
City __________________________________________ State __________ Zip ________________
Phone ______________________________________________
Email _______________________________________________
Membership Levels:
Please select one of the following:
□ Senior/Student/Teacher $15.00
□ Individual $25.00
□ Family $35.00
□ Legacy Club $50.00
□ Founders Club $100
□ Heritage Club $150
□ Curator's Club $250
New Member __________ Renewal ______________
_________________________________________________________________________________
_________________________________________________________________________________
Method of Payment:
□
Check
□
Visa
□
Mastercard
My Check for $ _______________ is enclosed.
Please make checks payable to Maumee Valley Historical Society (MVHS)
For Credit Card Payment, please include the following information:
Cardholder's Name: __________________________________________________________
Card Number: ______________________________________________________________
Expiration Date: ___________________________ 3-Digit Security Code: ______________
All or a portion of your donation may be
tax deductible. Please consult with your tax advisor.
Thank you!
The heritage of the Maumee Valley and its surrounding communities is preserved through membership in the Maumee Valley Historical Society. If you are interested in becoming a part of this great organization, print and complete this page and mail it to the MVHS office with your payment:
Membership Committee, 1031 River Road, Maumee OH 43537.
You may also fax the form with credit card information to 419-893-3108.
Close this page and visit the
"MVHS Mission"
link for more information
on membership.