Member Form This form can be used for new memberships as well as renewals. Name* First Last Address* Street Address Address Line 2 City State ZIP Code Phone*Email* Membership Option*Select one ...Friend of the Historical Society (Individual annual membership) - $15Supporting Member (Individual life membership) - $100Dual Supporting Members (Life membership for two individuals in the same household) - $150Benefactor (Individual life membership) - $250Total $0.00