Randolph Historical Society
P.O. Box 143
Randolph, New York 14772

MEMBERSHIP APPLICATION
 

Full Name(s) _______________________________________________________


Address ___________________________________________________________
 

City _________________________State ____________Zip Code ____________


Telephone Number ________________Membership Category ________________

Check enclosed for   $ ________________________

Make check payable to the Randolph Historical Society and mail to the above address

CATEGORIES OF MEMBERSHIP

MEMBERSHIP:  Any person or entity subscribing to the purposes of the Society and paying designated dues shall be eligible for membership in any of the following categories.

INDIVIDUAL:  Any person who meets the requirements for membership and who pays the annual dues of $20.00 per person and is entitled to one vote in Society meetings.

COUPLE:  (Individual and Spouse) Any couple who meet the requirements for membership and who pay annual dues of $30.00.  Both persons shall have one vote each in Society meetings.

FAMILY:  Covers a traditional family residing in a common household (parents and unmarried children living at home), and the annual dues are $40.00.  Each member of the family has one vote in Society meetings.

STUDENT:  Available to any student who is attending a school or college on a fulltime basis (entitled to one vote in Society meetings) First year is FREE, after that dues are $10.00 per year.

PATRON:  Those persons who contribute $50.00 to $99.00 per year to the Society, and have one vote in Society meetings.

BENEFACTOR:  Those who contribute from $100.00 to $249.00 per year to the Society.  Benefactor members have one vote in Society meetings.

SUSTAINING:  Those who contribute $250.00 or more per year to the Society.  Sustaining members have one vote in Society meetings.

LIFETIME:  Any person who meets the requirements for membership and pays one lump sum fee equal to twenty times the annual individual membership fee shall be a member for life.

DUES RUN FROM JANUARY 1 TO DECEMBER 31

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         MEMBERSHIP FORM
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The mission of the Randolph Historical Society is to educate the public and to collect, maintain, preserve and display for public viewing artifacts of local history from the Randolph Area.