Heritage League of Pierce County
PO Box 64345 . University Place . Washington . 98464 . info@piercecountyhistory.org
Copyright 2011

Heritage League of Pierce County
2011 MEMBERSHIP APPLICATION
>>New and Renewing Members<<

2011 Annual Dues (now through December 31, 2011)

          $ 20.00 - Heritage Organization                New                    Renewal

_____ Please check here if your organization has 501(c)(3) status (not required for membership)

          $ 15.00 - Individual             New                    Renewal

Please make checks payable to Heritage League of Pierce County and mail to:

HLPC, P.O. Box 64345, University Place, WA 98464. Please retain a copy for your records.

Organization Name:                                                                                                                                        

Organization Contact:                                                                                                                                        

Organization Mailing Address:                                                                                                                            

Telephone/Fax:                                                                                                                                                  

E-Mail Address:                                                                                                                                                 

Website:                                                                                                                                                          

Official Contact:                                                                                                                                              

Mailing Address:                                                                                                                                                

Telephone/Fax:                                                                                                                                                  

E-Mail Address:                                                                                                                                                 

Alternate Contact:                                                                                                                                          

Mailing Address:                                                                                                                                               

Telephone/Fax:                                                                                                                                                  

E-Mail Address:                                                                                                                                                 

Please provide two contact names: one being the official decision-making contact plus
one representative who will receive and respond to e-mail, notices, agendas, calls for action, etc. 

Thank you.

Questions?

E-mail: info@piercecountyhistory.org

Heritage League of Pierce County is a registered 501(c)(3) nonprofit corporation.