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 !
