Membership Classifications

Please print out, fill in, and send this form to:

Bradford County Historical Society
109 Pine Street
Towanda PA, 18848

Date_________________

____ Basic Society Membership - (Settler only) $25

____ Sustaining - (Settler and onsite research) $35

____ Family - (Settler and onsite research) $45

____ Student - (ID required) (Settler and onsite research) $15

____ Benefactor - (Settler and onsite research) $100

____ Patron - (Settler and onsite research) $500

____ Corporate - (Settler only) $500

____ Individual Life - (Settler and onsite research) $1,000

All memberships include a season pass to the museum

Permanent Address

Name:_______________________________________

Address:_____________________________________

            _____________________________________

City, State, Zip________________________________

Email Address:________________________________

Winter Address (November & February issues)

Address:_____________________________________

            _____________________________________

City, State, Zip:_______________________________

Email Address:________________________________