THE POLISH HERITAGE SOCIETY
Membership form
click for printable version
Please check one box below:
| New | Renewal | |
| Membership - $15/person | ||
| Student - $5/student(grade school and high school only) | ||
| Family, Business, or Organization - $30 | ||
| Life Membership - $125/person |
|
PLEASE PRINT |
Date | |
| Name | ||
| Address | ||
| City | ||
| State | Zip | |
| Phone | ||
| Yes, I am willing to work on a committee. Please contact me. | ||
| SEND TO: | Polish Heritage Society P.O. Box 1844 Grand Rapids, MI 49501-1844 |