The Historical Preservation Society
of Upper Township NJ Inc.
MEMBERSHIP APPLICATION
Name:________________________________________________________________________
Address:______________________________________________________________________
City:______________________________________________ State:___
Phone:____________________
Zip:____________
E-Mail:________________________________
Please make your check payable to HPSUT and remit with this form to:
The Historical Preservation Society of Upper Township NJ Inc.
(or HPSUT)
P.O. Box 658
Marmora, NJ 08223-0658
MEMBERSHIP POLICY: ____ Individual - $15.00
____ Couple (Husband & Wife) - $25.00
____ Senior Couple (Both 65+) - $20.00
____ Student - $5.00
____ Business/Organization - $75.00
Your tax deductible donation $ __________
Annual membership expires
Dec. 31st of each year.
THANK YOU !
The Historical Preservation Society of Upper Township NJ Inc. (HPSUT)
P.O. Box 658
Marmora, NJ 08223-0658
Historical Preservation Society of Upper Township NJ
Web: www.UpperTwpHistory.org
Facebook: www.Facebook.com/UpperTwpHistory
Twitter: http://Twitter.com/History_Upper
Email: UpperTwpHistory@Yahoo.com
Document1
Page 1