Fill out and send this form along with your check or credit card information to:

Windsor Historical Society

96 Palisado Ave.

Windsor, CT 06095

A membership card and our latest newsletter will be sent to you promptly.

    Membership rates (please check one)

      $25 Seniors (65 yrs +)

      $30 Individual

      $40 Family

      $100 Donor

      $250 Patron

      $500 Benefactor

      $300 Life (one-time payment)

      $450 Joint Life (one-time payment)

    Please print

    Name:               

    Name (joint memberships):

    Mailing address:           

    Telephone:

    Email:

    Email (joint memberships):

Payment

  Check                   Credit Card (Be sure the name and address above match that on the card*)

             Card Type (Visa, MC etc)__________________________
             

             Account Number_________________________________
            

             Expiration Date (Month/Year)_______________________
             

             Security Code (last 3 digits on back of card)___________

This gift will be matched by my/our employer(s):

(Please enclose matching gift form)