| Name |
Return completed Chapter application to: |
| Address | I. D. Smith, Treas. |
| City
State
Zip |
Charleston Chapter - NRHS |
| Phone
Fax |
133 Sampa Road |
| E-mail |
Mt. Pleasant, SC 29464-2527 |
| Occupation/Interest |
USA |
| Have
you ever been a member of NRHS?
Yes No
If yes, former membership # if available: |
Charleston Chapter applicants should make check payable to: Charleston Chapter - NRHS |
| Membership Classes |
||
| Associate Membership |
Chapter and NRHS (all rates are USD) |
Chapter Only |
| $33.00 ____ |
Regular (Chapter
$20.00 + NRHS Regular $33.00) Primary voting
class $53.00 ____ |
$20.00 |
$16.00 ____ |
Regular - NRHS Student
(Chapter $20.00 + NRHS Student
$16.00)
(available if under age of 18) Year of birth: $36.00 _____ |
$20.00 |
| $ 5.00 ____ |
Family -1 (Chapter
$3.00 + NRHS Family $5.00) Non-voting
class
$ 8.00 _____ |
$ 3.00 |
| Add-on name:
|
||
| $ 5.00 ____ | Family -2 (Chapter $3.00 + NRHS Family $5.00) Non-voting class $ 8.00 _____ | $ 3.00 |
| Add-on name:
|
||
| $ 5.00 ____ | Family -3 (Chapter $3.00 + NRHS Family $5.00) Non-voting class $ 8.00 _____ | $ 3.00 |
| Add-on name:
|
||
| Friend of the Charleston Chapter (Chapter only $20.00)
$20.00 _____
|
$20.00 |
|
| Total _____ (mail address below) |
(Membership
class descriptions,
requirements and availability are subject to change w/o notice)
Total
_______
(mail to address above)
|
|
| Associate applicants may pay with Visa, Discover, MasterCard, or AMEX: Name on card : Card
#:
Expiration Date:
Authorization
signature on
application
signature
line
|
I agree to abide by the Constitution & By-laws of the National Railway Historical Society: Signature: Date: Application and credit card signature/ Parent or Guardian
for student
Thank you for your application. Signature of approving Chapter officer: |
| Associate application check should be made payable to: National Railway Historical Society 100 North 20th Street, 4th Floor Philadelphia, PA 19103-1443 USA |
National Office Use Only 84
Start Stop
Class Chapter
Number Received
Processed |