LCHS MEMBERSHIP APPLICATION
DATE:  _____________

NAME: ______________________________________________________

ADDRESS:  __________________________________________________

CITY / STATE / ZIP:  __________________   ____   _________

PHONE:  ______  ________________

E-MAIL:  _________________________________

BUSINESS NAME: ______________________________________________

BUSINESS ADDRESS: __________________________________________

CITY / STATE / ZIP:   _________________  _____  __________

TYPE OF MEMBERSHIP
Check Appropriate

_____  INDIVIDUAL     _____  BUSINESS

_____DUES ENCLOSED

_____BILL ME

Send Membership Application to: Logan County Historical Society
                                                   PO Box 1512
                                                   Guthrie, OK 73044
Membership Dues
P.O. Box 1512
Guthrie, Oklahoma
73044
405.282.6000