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Join The Douglaston & Little Neck Historical Society

  Please print this page, fill it out and mail it along with your check to:

Lori Finck / Treasurer
Douglaston/Little Neck Historical Society
372 Grosvenor Street
Douglaston, NY 11363
Please enroll me as a new member, or renew my membership in
the Douglaston/Little Neck Historical Society.


MEMBERSHIP CATEGORY: (Check one)
__ Regular, $25
__ Contributing, $100
__ Business, $150
__ Life, $250 one-time payment
__ Benefactor, $500 one-time payment (with Trustee approval)


 
_______________________________________________________
Name
_______________________________________________________
Address
_______________________________________________________
Address
_______________________________________________________
Telephone Number
_______________________________________________________
Email Address


I would like to serve on the:
__ Research & Archive committee
__ Architecture committee
__ Events/Entertainment committee
__ Publications committee
__ Community Relations committee