Concord Historical Society
Membership Application

Name:_____________________________
Address-Street:________________________
City:___________ State:______ Zip:________
Home Telephone:_______________________


Please make your check for: 
__ $10.00 Annual regular membership
__ $50.00 Life Membership
__ $5.00 Annual Senior or Junior Membership

Payable to:
Concord Historical Society
c/o Grace Gentner
118 South Central Avenue
Springville, NY 14141

Do you have a moment to spare? We could sure use your help!
Please check the activities or projects that you would be willing to assist.

( ) Museum host/hostess for Sunday afternoons (2-4pm)
( ) Erie County Fair exhibit
( ) Membership Committee
( ) Annual spring or general housecleaning
( ) Outside yard work - weeding, planting, trimming, etc.
( ) Painting     ( ) On ladders     ( ) Off ladders
( ) Newsletter committee
( ) Historical Research/Cataloging
( ) Assist with development of museum exhibits
( ) Assist with museum interior restoration
    ( ) drywall/plaster     ( ) carpentry     ( ) paint     ( ) wall covering
( ) assist with fundraising efforts
( ) none of the above, but I can help the Concord Historical Society by:
_____________________________________________________
_____________________________________________________

We are interested in you!
Do you have an item of historic interest that you'd like to share with us? Perhaps you live in an older home with an interesting story, perhaps your grandparents or great-grandparents related a story regarding early times in the Town of Concord, or maybe you have stumbled upon your own item of local interest. You may be able to share a "history related" craft.

Please us the space on the back to summarize
"A bit about you"

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