Application

Type of Membership:

 Annual Individual $ 20

 Annual Family $ 50

 Annual Business $ 100

 Life Individual $ 100

 Life Family $ 150

 Donation $______

 I want to volunteer (We will contact you)

Name(s): ________________________________

Address: ________________________________

City, State, Zip: ________________________________

Phone(s): ________________________________

E-Mail: ________________________________

We cordially invite your membership and donations to the Boxborough Historical Society. All contributions are tax deductible.

Please mail your completed application, along with your check made payable to “Boxborough Historical Society, Inc.”, to us at:

29 Middle Road

Boxborough, MA 01719

Your donation and your membership are greatly appreciated. Thank you for your support.