Name:  _____________________________________

Address:  _____________________________________

Email:  _____________________________________

Phone:  _____________________________________

Please make checks payable to
                          North Salem Historical Society
and mail to
                Post Office Box 31, North Salem, New York 10560

□  I’d like to volunteer to help with events.  Please contact me by  □  phone or □  email.

   
□   $25 individual/ family
   
□   $50 contributing

□   $100 business/professional

□   $500 life

□   _____donation.

 Please use my additional donation for the following:

_____ Preservation     _____ Building Fund

_____ Acquisitions     _____ As needed

Visit us at:    www.nshs.info
email:  northsalemhistoricalsociety@gmail.com