Chittenden County Historical Society Membership Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out and submit this form. Don't forget to complete your application by submitting payment.

Membership Renewal or New Member *

Renewal

New Member

GIFT MEMBERSHIP (include giftee name and address below)

Last Name *

First Name *

Mailing Address *

City/Town *

State *

Zip Code *

email address *

Membership Type *

Family ($25)

Individual ($25)

Special Rate ($15) - Member of town historical society

Special Rate ($15) Student/Educator

Corporate ($25)

Sustaining ($50)

Life Member ($500)

Gift Membership ($10)

How did you find out about CCHS? *

Attended a CCHS Program

Facebook

CCHS Website

CCHS Brochure

Word of mouth

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report