JCHS Membership Application

Jefferson County Historical Society
JCHS Mission: To actively discover, collect, preserve, and promote the heritage of
Jefferson County in the State of Washington.

MEMBERSHIP APPLICATION

I would like to join efforts to discover, collect, preserve, and promote the heritage
of Jefferson County in the category noted:

_____Senior/Youth - $20
_____Individual - $30
_____Family - $40
_____Patron - $100
_____Benefactor - $250
_____Sustaining - $1,000

Name ________________________________________________________________________________

Address _____________________________________________________________________________

City ________________________________________________ State ______ Zip __________________

Phone _____________________________ email _____________________________________________

If you would like to charge your dues to your credit card, call 360-385-1003
Send this form with your membership dues to:
Jefferson County Historical Society
540 Water Street
Port Townsend, WA 98368