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The Historical Preservation Society of Upper Township NJ Inc.

Becoming a Member

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PLEASE PRINT THIS FORM

The Historical Preservation Society

of Upper Township NJ Inc.

MEMBERSHIP APPLICATION

Name:________________________________________________________________________

Address:______________________________________________________________________

City:______________________________________________State:_______Zip:____________

Telephone:____________________E-Mail:________________________________

Please make your check payable to HPSOUTNJ and remit with this form to:

The Historical Preservation Society of Upper Township NJ Inc.  (or HPSOUTNJ)

P.O. Box 658

Marmora, NJ 08223-0658

MEMBERSHIP POLICY:      ____ Individual @ $15.00/ea

                                          ____ Couple (Both under 65) $25.00

                                          ____ Sr. Couple (Both 65 or older) $20.00

                                          ____ Student @ $5.00/ea

THANK YOU !