Individual Membership – $5
Family Membership – $10
Individual Life Membership – $50
Business Membership – $100
Sponsor – $500
Patron – $1000
Benefactor – $5000
Honorary Membership – no fee

To join, renew, give a gift, or donate please print this page, fill it out and mail with your payment to:
East Montpelier Historical Society, PO Box 63, East Montpelier, VT 05651:

Name __________________________________________________

Street/PO _______________________________________________

State/Zip________________________________________________

Phone____________________________________________

Email____________________________________________

Membership Type(See list above) ____________________

Donation in Memory of (optional)

__________________________________________________

Amount Enclosed____________________