Published on Historical Society of Pennsylvania (http://hsp.org)

Affiliates Membership Form

This is the form for joining or renewing as a History Affiliate member. For more information about Affiliate membership benefits, please contact Prudence Haines, Director of History Affiliates, by phone at 215-732-6200 ext. 243 or by email.

Organization Location

Address 1: *

Address 2:

City: *

State: *

Zip:

History Affiliates Member Information

Contact Name:

Contact Email:

Mailing Address 1:

Mailing Address 2:

Mailing City:

Mailing State:

Mailing Zip:

Phone:

Website:

Leave this field blank:

Source URL (retrieved on 5/22/13): http://hsp.org/history-affiliates/affiliates-membership-form