Bayonne Historical Society, Inc.
MEMBERSHIP APPLICATION FORM

To become a member of the Bayonne Historical Society, print out the following page, complete the form, enclose your check, and mail to:

Bayonne Historical Society, Inc.
P.O. Box 3034
Bayonne, NJ 07002-0297

Name _________________________________ Date ____________________________

Address _______________________________ Telephone _______________________

City, State, Zip Code _____________________________________________________

The purpose of the Bayonne Historical Society, as stated in our Constitution, is "to increase the historical knowledge of Bayonne to the public, thereby promoting civic pride."

Membership is open to anyone who expresses interest in our purpose.

Basic Membership:

____ Individual (non-business) $15.00
____ Family $20.00
____ Student/Senior Citizen $10.00

Special Membership:

____ Basic Business $25.00
____ Sponsor $50.00
____ Contributor $100.00
____ Patron $500.00

Membership Enclosed _______________
____ New Membership
____ Renewal

Membership is good for one year.

Please make all checks payable to: The Bayonne Historical Society, Inc.