***** MEMBERSHIP APPLICATION *****

(Print this form)
Please enroll me as a member of the Jewish Historical Society of Greater New Haven, Inc.
(Membership year is from July 1st to June 30th. All new applications received after Jan. 1st are accepted for the following year.) 

    Individual Membership ($25.00)            $____________

    Family Membership ($36.00)                $____________

    Patron ($50.00)                           $____________

    Organizational Membership ($36.00)        $____________

    LIFE MEMBER ($200.00)                     $____________

    Youth (under age 21) ($18.00)             $____________


*****DONATIONS *****

     Please accept my donation to the:

       Harvey N. Ladin Archives Fund           $____________

       Rabbi Arthur Chiel Fund                 $____________

       Louis Sachs/Isadore Wexler Fund         $____________

       Arthur M. Spiegel Memorial Fund         $____________

       General Fund                            $____________

       Donation is in |honor|memory| of:_________________________


                      TOTAL ENCLOSED           $____________


    NAME________________________________________________________

    STREET______________________________________________________

    CITY, STATE, ZIP____________________________________________

    TEL.________________________________________________________
Please make your check payable to "JHS of Gr. NH" and mail with this form to:

The Jewish Historical Soc. of Greater New Haven
P.O. Box 3251
New Haven, CT 06515

NOTE: All dues and donations are tax deductible within the provisions of the federal tax laws.

Any questions? Tel. (203)392-6125 or e-mail to: whirsch@snet.net

THANK YOU FOR YOUR DONATION

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Updated October 3, 2002 8:03 AM