S​outhampton Historical Society

Southampton Historical Society

241 Millers Corner Road    Clearville, PA 15535

      www.southamptonhistoricalsociety.com

 

“The mission of the Southampton Historical Society is to preserve all aspects

of the rich history for the residents, descendants and future generations of

Southampton Township, Bedford County, Pennsylvania”

 

Membership Application

$10.00 per year & receive two newsletters ~  January 1 through December 31

 

_____ New Member        _____ Renewal Membership     

 

(Please print)

Name _______________________________________________________________________

Last~ First Name~ Middle Initial

 

Address _____________________________________________________________________

 

City_________________________________________________________________________

 

State ______________________________________________ Zip ______________________

 

Phone ______________________________________________________________________

 

E-mail ______________________________________________________________________

 

 

Please accept my tax deductible donation______________________ 501(c)(3) non-profit status.

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Total enclosed _____________

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For Society Use Only

 

Date Received ______________ Amount Paid ____________Cash ___   Check #_________