Membership Form ~ Heritage League of Pierce County

Heritage League of Pierce County
2010 MEMBERSHIP APPLICATION
>>New and Renewing Members<<

2010 Annual Dues (now through December 31, 2010)

$ 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 2361, Gig Harbor, WA 98335. 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?

Contact the Vicki Blackwell at 253.858.6722
or e-mail: info@piercecountyhistory.org

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