Historians of Sterling Township

Membership Application

 

Name: _____________________________________________________     Date: ____________________________

 

Address: _______________________________________________________________________________________

 

City/State: __________________________________________________     Zip: _____________________________

 

Phone: _________________________________     Cell: _________________________________

 

Email: _________________________________________________________________________________________

 

Alternate Address (If Applicable): __________________________________________________________________

 

_______________________________________________________________________________________________

 

Dues $15 per person.  Checks to be made to:

H.O.S.T.,

P.O. Box 48,

Sterling, PA 18463