The Pueblo County Historical Society Membership Form


Annual Membership
Student   $12 Sponsor  $ 200
Single  $35 Patron  $300
Couple/Family  $45 Benefactor  $1,000
Supporting  $80 Institutional/Corporate   $1,000

Name:
(If you chose family membership above, list their names.)
Address:
City, State & Zip:
       
Phone
Business Phone:
Email Address:
This Membership is
New
Renewal
Gift Membership
Comments:

Please print this application and mail it along with your check to
Pueblo County Historical Society
201 West "B" Street
Pueblo, Colorado 81003