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Costa Mesa Historical Society
Membership Application
Please print this application form, complete it and send it
with your donation to:
Costa Mesa Historical Society
PO Box 1764
Costa Mesa, CA 92628
| Name: |
________________________________________________________ |
| Street address: |
________________________________________________________ |
| City, state, ZIP: |
________________________________________________________ |
| Phone number: |
________________________________________________________ |
| E-mail address: |
________________________________________________________ |
Annual Membership Categories
| Individual |
$15.00 |
| Student (under 16 years) |
$5.00 |
| Family |
$20.00 |
| Contributing |
$50.00 |
| Business & Professional |
$100.00 |
| Public Agency |
$100.00 |
| Benefactor |
$250.00 |
| Santa Ana Army Air Base Wing |
$10.00 |
| Life Membership |
| Costa Mesa Historical Society |
$1,000.00 |
| Santa Ana Army Air Base Wing |
$50.00 |
Area of interest:
[ ] Estancia [ ] SAAAB [ ] Costa Mesa Historical Society
Volunteer work in which you are interested:
[ ] Assisting patrons with research questions and projects
[ ] Helping to catalog our photo and other collections
[ ] Clipping newspapers for historical articles
[ ] Staffing our booth at the Lions Fish Fry
[ ] Speaking to schools and other organizations about Costa Mesa
history
[ ] Hospitality Chairman for general meetings
[ ] Making desserts to serve at our meetings
[ ] Working with our textile collection
[ ] Telephoning for meetings, etc.
[ ] Working as a Docent at Diego Sepulveda Adobe
[ ] General office work
[ ] Computer input
[ ] Janitorial work
[ ] Other _________________________________
By submitting this form with your dues payment, you will automatically be
added to our postal mailing list. If you would also like your e-mail address
to be added to our e-mail announcements list, please check this box:
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