Locust Valley Historical Society
Annual Dues $10.00
For the Year January 1, ________ - December 31, _____________
My check for $ ________________ is enclosed for Annual Membership.
City _________________________ State ________ Zip ___________
Telephone No. (optional) ________________
My Membership is:
|Please make check payable to Locust Valley Historical Society.
Membership contributions are tax-deductible to the extent allowed by law.