Print this form, fill out and return along with your check to the address listed.
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Join The Fort Miles Historical Association
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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: _____________________ |
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Please check one: |
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□ 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 $10. |
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Enclosed is my check in the amount of:$____________ Make Checks payable to:
Fort Miles Historical Association Dr.Gary Wray, President 120 E. Wild Rabbit Run Lewes, DE 19958
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