Print  this form, fill out and return along with your check to the address listed.

Join The Fort Miles

Historical Association

 

 

Help us preserve, restore and protect this remarkable site--become a member of the Fort Miles Historical Association simply by filling out the form below and mailing it with your check to the address listed below.

 

Name: _______________________________________

Address: ___________________________________________________

____________________________________________________________

City: _________________, State__________ Zip: ________________

Phone: (___) _______________

Email: _____________________

Please check one:

 

□  General  261st Coast Artillery  (life member) $1,000.

□  Colonel , 261st Coast Artillery $500.

□  Major, 261st Coast Artillery $250.

□  Captain, 261st Coast Artillery $100.

□  Small Business $75.

□  Dual/Family  $20.

□  Individual  $15.

□  Student   $10.

 

 

 

 

 

 

 

Enclosed is my check in the amount of:$____________

Make Checks payable to:

 

Fort Miles Historical Association

Dr.Gary Wray, President

120 E. Wild Rabbit Run

Lewes, DE 19958

 

 

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