APPLICATION FOR MEMBERSHIP


Greater Buckeye Lake Historical Society 

P.O. BOX 1

Buckeye Lake, Ohio 43008 


                        Date______________________


                        Name___________________________________________________________________________________________________


                        Address________________________________________________________________________________________________


                        City_________________________________________   State_______________________________   Zip_____________


                        Home Phone__________________________________   Cell Phone____________________________________

                        Email Addres________________________________________________________________________________________


   Work/Business_____________________________________________________________________________________


Memberships are for one year.

​Membership Category:

Individual $25      Couple or Family $35      Organization or Business $75 

Lifetime: (One Time Payment) $500


Additional Comments & What Talents Would You Like to Contribute: 






Please print and fill out this form and send with a check to the address above.  


www.buckeyelakehistory.org
740-928-2920

Join Pay By Check

The Greater Buckeye Lake Historical Society​​