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

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

If you are human, leave this field blank.

lakescugoghistoricalsociety @gmail.com