Membership Application

HSHC memb form adapted for internet HISTORICAL SOCIETY OF HOPKINS COUNTY MEMBERSHIP FORM– Date ____________ Enclosed is $25.00 for ANNUAL MEMBERSHIP (Membership for 1 year only – 1 Yearbook) Year:  ________________________ Enclosed is $40.00 for FAMILY MEMBERSHIP  (Membership for 2 family members but only 1 Yearbook) Year:______________ Enclosed is $250.00 for LIFE MEMBERSHIP (Name included in Yearbook)   NAME: _______________________________________________________________

Family Membership–SPOUSE NAME:________________________________________________________

TELEPHONE _______________________

ADDRESS: Street City State Zip Code ______________________________________________________________________________________   Return to:  Historical Society of Hopkins County, 107 Union Street,  Madisonville, KY  42431 The Historical Society of Hopkins County is a 501 (c) (3) tax-exempt corporation. YOU may copy and paste this to a word document or print from link;  Or call 270-821-3986 during weekday business hours M-F  12 noon – 4 pm for further assistance.

Donations above membership dues are always welcome.

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