NUTLEY HISTORICAL SOCIETY
65 Church Street
Nutley NJ 07110
973-667-1528
The Nutley Historical Society is a
not-for-profit organization
dedicated to serve the educational, cultural and
historical
needs of our community.
I (we) __________________________________ (print
name)
wish to _ apply/ _ reapply for membership in
The Nutley Historical Society
for the year _____ in the following category:
| Annual Student | $5.00 | ____ |
| Annual Individual | $15.00 | ____ |
| Annual Couple | $20.00 | ____ |
| Annual Family | $25.00 | ____ |
| Lifetime Individual | $150.00 | ____ |
| Lifetime Couple | $200.00 | ____ |
| Lifetime Family | $250.00 | ____ |
| Annual Business Patron | $50.00 | ____ |
| Lifetime Business | $500.00 |
_____
|
| Additional Donation | _______ | _____ |
Signed _____________________________________________
Print Name _________________________________________
email (optional) __________________________________
Address ____________________________________________
City _____________________ STATE _____ ZIP __________
Phone ______________________________________
Send check and application to:
Nutley Historical Society, 65 Church St., Nutley, NJ 07110