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The Gann Historical Society & Library, Inc.
- Membership Application -

Membership year is from July 1st to June 30th of the following year

Mr. [ ] Mrs. [ ] Miss [ ] Ms. [ ] ____________________________________________

Address _____________________________________________________________

E-mail  ________________________________________ Fax ___________________

City ________________________________State ___________ Zip ______________

Telephone_(________)_ __________________ Date ________________

 

Individual Membership: $20 [ ] Family Membership: $30 [ ]

New Membership [ ] Renewal [ ] Change of Address [ ]

 

Gift membership from: ________________________________________________

(Use name/address space above for recipient's information)

 

Donation: $____________ Company/Matching: $____________

(100% TAX DEDUCTIBLE)


Mail to:
Gayle Gann
5228 Forsyth Road # 246
Macon, GA 31210