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| If you wish to support the Society please print the form below and send it with your information and check to the Somers Historical Society. Somers Historical Society Membership Application Annual Dues (January-December) Membership Level (please check one): ____Individual, $20 ____Patron, $100 ____Family, $30 ____Corporate, $250 ____Sustaining, $50 ____Life, $300 Application (please fill-out): Name(s) ______________________________________________ Address _______________________________________________ Phone ______________________ E-mail ______________________ Amount $_______________ MAIL TO: Somers Historical Society P.O. Box 336 Somers, NY 10589 ATTN: MEMBERSHIP |