Please include the following:
Name______________________________________
Address____________________________________
Line 2 _____________________________________
City_______________________________________
State________________________
Zip Code_________________
Telephone #(___)_______________________
Email Address:______________________________
Please make checks payable
to the:
Clinton County Historical Association
|
_____ Student (K-12) |
$ 10.00 |
|
|
My tax-deductible gift of ______ is enclosed.
Mail this completed application
and
your check or money order to: Clinton County Historical Assoc.
98 Ohio Avenue
Plattsburgh, NY 12903 Telephone: (518) 561-0340
or email:
director@clintoncountyhistorical.org
|
| _____ Individual |
$ 30.00 |
|
|
_____ Family |
$ 50.00 |
|
| _____ Business
|
$ 50.00 |
|
|
_____ Friend |
$ 90.00 |
|
| _____ Patron
|
$150.00 |
|
|
_____ Sponsor |
$ 300.00 |
|
| _____ Sustaining |
$ 600.00 |
|
|
_____ Life |
$ 1,500.00 |
|
| _____ Corporate |
$ 1,500.00 |
|
School Groups are free
(Rates
effective until December 31, 2007)
Last updated:
01/15/2008