MEMBERSHIP APPLICATION

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Campbell County Historical Society

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Telephone Number *

Email Address *

I prefer to receive an electronic copy of the newsletter (optional)

Are you a new member or renewing? *

NEW

RENEW

Membership type *

Single - $20 per year

Joint - $30 per year (for a couple)

Lifetime - $200 per person

Donation (CCHS is a 501C3 organization)

I am interested in volunteering at the Campbell County Museum at the Historic Courthouse

Required

How would you like to pay?

[If you plan to pay online using PayPal, please return to this form to click SUBMIT. This will record all your selections]

I plan to pay via PayPal - Please return to this form to hit SUBMIT after completing my PayPal transaction

No, I am paying via check/in-person - Please be on the lookout for my check in the mail.

For your convenience you may click here to Pay Online - by entering the appropriate membership or donation amount. Please note that you will need to return to this page in order to SUBMIT this form.

Please make checks payable to the Campbell County Historical Society (CCHS) and mail them to:

CCHS

PO Box 595

Rustburg, VA, 24588

Newsletters (The Chronicle) are mailed four times yearly in January, April, July, and October. Programs are held in the same months, on the last Sunday at 2:30 p.m. in our Community Room.

Help keep Campbell County heritage alive. Join today!

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