1996 Membership Sign Up Form

Yes! Please Enroll me/us

as member(s) of the

Edgewater Historical Society.

Enclosed are my/our dues.

Individual*.........$10.00
Family*.............$15.00
Patron..............$50.00
Student (under18)....$1.00
Senior Citizen.......$5.00
Business (minimum)..$50.00

Yes! I/we support the

Edgewater Historical Society

Museum at 5358 N. Ashland Ave.

Enclosed is a donation.

Chief........$5,000 or more
Captian......$1,000 - $4,999
Brass Pole.....$500 -   $999
Brigade........$100 -   $499
Hose Crew.......$50 -    $99
Dalmation.......$

Enter your Name(s)
Enter your Address here
City, State, Zip
Phone number
Enter your E-Mail address here

Fundraising
Collections
Finance

Membership
Program
Bd.Development

Historical Sites
Property
Communications

Make checks payable to :

Edgewater Historical Society

Please mail completed for and your check to:

Jim Anderson

Edgewater Historical Society

1718 West Gregory

Chicago, IL 60640

Contact: 773.907.1872 for furthur information

All contributions are tax-deductable to the extent allowable by law.

Thank you for your support.