ASPBH Membership Application

Page updated on Jun 14, 2011 at 11:07 AM

Alexandria Society for the Preservation of Black Heritage Inc.
Membership Application

Please print and complete this form and mail it with a check or money order payable to:

 The Alexandria Society for the Preservation of Black Heritage, Inc.
(ASPBH. Inc.)
P.O. Box 3527
Alexandria, Virginia 22302
 

Membership Term (Select One)
Fiscal year   1 January   31 December  
 
Membership Type (Select One)
Organization / Corporation
$250.00 per year
 
Family / Couple
$35.00 per year
 
Adult
$20.00 per year
 
Youth (under 18)
$5.00 per year
 
 
Member Information
Name:
Family Member(s):
(if applicable)

Address:  
City:   

State: 

 

Zip Code: 

 
Telephone:  
 
Interested in Volunteering? (Select One)
YES   NO  
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