MEMBERSHIP APPLICATION

 
Baptist History and Heritage SocietyTo send by U.S. Postal Mail, print out this page and mail to the address listed at the bottom.

Click Here to Download an Application to Your Computer.
(By saving it to your computer, you can type in the answers
and mail the application.)
 

Yes, I want to apply for membership in the Baptist History and Heritage Society as:

___  Regular Member

___  Sustaining Member

____________________________________________________________________
Name (Title: Dr., Rev., Mr., Ms., etc.)

____________________________________________________________________
Street Number / Box Address

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City                                                     State                                     Zip

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Phone                                     Fax                             Email

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Date

____________________________________________________________________
Signature

Rates for Institutions

Applies to all libraries, churches, associations, conventions, fellowships, educational institutions, and other organizations.

  USA Outside USA
1 Year Membership $50.00 $65.00
2-Year Membership $90.00 $125.00
3-Year Membership $135.00 $180.00



Rates for Individuals

  USA Outside USA
1-Year Membership $40.00    [  ] $55.00       [  ]
2-Year Membership $75.00    [  ] $100.00     [  ]
3-Year Membership $105.00  [  ] $150.00     [  ]
1-Year Student* $30.00    [  ] $50.00       [  ]
1-Year Senior (60+) $30.00    [  ] $34.00       [  ]
2-Year Senior (60+) $55.00    [  ] $95.00       [  ]
3-Year Senior (60+) $80.00    [  ] $140.00     [  ]
Life Membership $750.00  [  ] $1,050.00  [  ]
Sustaining Member** $100.00  [  ] $100.00     [  ]

*A student must provide name and address of institution in which he/she is a full-time student.
**A Sustaining Membership requires selecting a regular membership plus making a contribution of $100 or more to the BH&HS.
 

PAYMENT ENCLOSED (Make check payable to the Baptist History and Heritage Society)

Print and Mail to:  BH&HS, 151 Broadleaf Drive, Macon, Georgia 31210