Membership Form – Lake Scugog Historical Society

Membership Form

Membership

New

Renewal

Name

First

Last

Address

Phone

Date

Single - $15.00

Family - $25.00

Corporate/Business/Organization - $50.00

Life Membership (tax receipt) - $300.00

Business Name

E-transfer: lakescugoghistoricalsociety@gmail.com

or by cheque payable to Lake Scugog Historical Society
Send to:
LSHS
c/o Books Galore
175 Perry Street
Port Perry, On.
L9L 1B8

Please let us know how you plan on paying or how you paid:

E-Transfer

Cash dropped off at Books Galore

Cheque made out to Lake Scugog Historical Society

If you are human, leave this field blank.

lakescugoghistoricalsociety @gmail.com