Please fill out the Membership Application below, then click on
the "Submit Query" button at the bottom, to pay for your Membership.
Membership Application
Name
Address
City
State
Zip Code
Home Phone with Area Code
Work Phone with Area Code
Cell Phone with Area Code
Your E-Mail Address
Referred by
Additional Comments or Talents you would like to Offer the Society.
Please Choose the type of Membership requested.
Individual $20
Couple or Family $35
Organization or Business $50
Sustaining $100
Lifetime (One Payment) $500
If you have any problems with this form, please send an e-mail to
j-me@buckeyelakehistory.org
