The deadline for the MEMBERSHIP dues is July of each year.

PLEASE PRINT THIS MEMBERSHIP APPLICATION FORM AND MAIL TO ADDRESS BELOW.

A receipt will be sent ONLY if requested. ALL donations and dues are federally tax-exempt.

Please make your CHECK PAYABLE TO:

Botsford Family Historical Association, Inc.
c/o Helen Botsford Faucher
Executive Secretary, 215 Buckingham Ave.
Milford, CT 06460

MEMBERSHIP APPLICATION FOR
BOTSFORD FAMILY HISTORICAL ASSOCIATION, INC.

Enclosed herewith is my check for $
Dated as follows:  
MEMBERSHIP DUES:
Household Membership
(adult couple or single person @ $10)		 $
Junior Membership
(under 18 yr. old @ $2.50)		 $

Name: _________________________________________________

Name: _________________________________________________

Name: _________________________________________________
(Note: Maximum dues for family $15.00)
List your Line of Descent: __________________________________
**A membership card will be sent upon request**

Check here if you would like a Membership Card: _______

Check here if you would like a receipt: _______
 

I'D LIKE TO MAKE A DONATION TO THE BOTSFORD FAMILY HISTORICAL ASSOCIATION.

General Fund $
Genealogical Fund $
Other: Contact Executive Secretary at the address above.

If you have any questions, please contact Helen at the address above or by email at botsy@optonline.net.

 
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