Please send your completed membership form, with your dues, to Mike Braman P.O. Box 306 Hillsdale, MI 49242

   Date: _________________     Name: _____________________________________________________

Complete Address:_______________________________________________________________________________________

_______________________________________________________________________________________

Phone: _______________________________                                      

email: _____________________________________________________________________________________

     Please circle one category for Membership Dues

   Single Member-$12.—    Family-$15    Life Member-$125    Senior Citizen Life Member-$75     Business/Professional Member-$20

   Please check the activities you would like to participate in

   ___Contribute baked goods for events at the Poorhouse    ___Act as a docent at the Poorhouse ___Act as a docent at the Fairgrounds Museum during the Fair