Membership Application Form

Membership Application Form
If you would like to join the De Pere Historical Society, forgot to renew your membership, or would like to send a friend a gift membership, use this form. All members will receive the newsletters regarding families and events in De Pere history and Historical Society news.

Please check one: ¨ $20 ¨ $50 ¨ $100 ¨ $200 ¨ Other ¨ Check here if this is a new address Mail To: De Pere Historical Society 403 N. Broadway De Pere, WI 54115 (920) 336-3877	This membership is for… Name:_________________________________ Street Address: ______________________________________ ______________________________________ City: __________________________________ State: _______ Zip: _______ Phone: __________________________ Email: ___________________________
	If this is a gift membership, this gift is from… Name: ________________________________ Street Address: ______________________________________ ______________________________________ City: __________________________________ State: _______ Zip: _______ Phone: __________________________ Email: ___________________________ A special gift notice will be mailed to the recipient with your name on it.

Membership Expires: December 31, 2008