Historical Society Membership Form
Please fill in, print out and mail to:

Membership Chairperson
c/o Historical Society
Memorial Town Hall
Newtonville, NY 12128-0508

Name:

Address:

City:   State:   Zip Code:

Telephone Number:

I would like to become a member of The Historical Society of the Town of Colonie, New York, Inc. in the classification I have checked below OR renew my membership as noted below:

Classification Annual Dues Classification Annual Dues
Students, Grades K-12 $1.00 Business $25.00
Senior Citizen $5.00 Sustaining Corporation $250.00
Individual $8.00 Benefactor $250.00
Family $10.00

My annual dues in the amount of $ are enclosed.

Programs you would like to see offered: