Application

WAYNESVILLE HISTORICAL & PRESERVATION SOCIETY, INC.

PO BOX 87
WAYNESVILLE, GA 31566

MEMBERSHIP APPLICATION

NAME_____________________________

SPOUSE NAME_________________

CITY_____________________________

STATE ___________

Email Address__________________________

ZIP_______

ADDRESS________________________________________________________

Phone#____________________

(PLEASE CHECK APPLICAPABLE BOX(ES)

[ ] SINGLE MEMBERSHIP $10.00

[ ] FAMILY MEMBERSHIP $15.00

SPONSORSHIPS

[ ] LIBRARY CENTURY CLUB $100.00

[ ] LIBRARY BENEFACTOR CLUB $250

[ ] PRESIDENTS CLUB $500

[ ] HISTORICAL GIFT $________

[ ] Check here if you would like a tax certificate for income tax purpouse

Library Century Club - $100 or more
Your gift of $100 or more entitles you to:
* A personilized Certtificate of Appreciation
* A beautiful calendar magnet

Library Benefactor Club - $250 or more
As a Library Benefactor Club members you will receive:
* A personilized Certtificate of Appreciation
* A Confederate Park T-shirt with your name Embroidered on it:

Presidents Club - $500 or more
Presidents Club members are rewarded with:
* A personilized Certtificate of Appreciation
* A special commemorative coffee mug
* A Confederate Park T-shirt with your name Embroidered on it:

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