Membership Form
Membership in the East Lyme Historical Society helps to preserve and maintain the Thomas Lee House, Little Boston School House, and other historical resources of the Town of East Lyme. We are a completely volunteer organization and a 501 (c)(3).
If you would like to become a member of the East Lyme Historical Society, you may download this form as a .pdf here, or print this page, fill it out and mail it, with your check, to:
East Lyme Historical Society
P.O. Box 112
East Lyme, CT 06333
Attn: Membership Chair
| Name | _______________________________________________ |
| Address | _______________________________________________ |
| Town/City,State,Zip Code | _______________________________________________ |
| Telephone | _______________________________________________ |
| Email address | _______________________________________________ |
| Website (Business members) |
_______________________________________________ |
Please enroll me as a Member at the following level:
| Student | $5.00 | ____ |
| Individual | $15.00 | ____ |
| Family | $25.00 | ____ |
| Sustaining | $25.00 | ____ |
| Lifetime (per individual) | $150.00 | ____ |
| Business | $50.00 | ____ |
I would like to make a tax-deductible contribution in the amount of _____
