WELCOME!



APPLICATION  FOR  MEMBERSHIP

 

DATE:_______________________________________________________________

 

NAME:_______________________________________________________________

 

ADDRESS:____________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

 SUMMER ADDRESS:___________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

PHONE:_______________________________________________________________

 

CELL PHONE:__________________________________________________________

 

EMAIL: _______________________________________________________________

(This the best way to keep you informed)

 

INSTRUCTIONS:  Make check payable to "Manatee County Historical Society"

Mail to:  MCHS

              4501 Manatee Ave West #234

              Bradenton, FL 34209-3925