Membership, Donations, and Sponsorship Form

Please fill out and select the items you would like to purchase. For Mail-in payments, please print the copy you receive in your email, and mail in with your payment.

Name: *

Address: *

Phone: *

Email: *

Select Membership:

Seniors & Students: $10.00

Senior Couple: $20.00

Individual: $20.00

Family: $30.00

Organization: $25.00

Business: $100.00

Cities or Towns over 5k: $500.00

Cities or Towns under 5k: $250.00

Townships over 10k: $1000.00

Townships under 10k: $250.00

County: $2500.00

Individual Lifetime: $500.00

Sponsorship of 'The James' $200.00

Don Peasley Photo Collection: Suggested Donation: $200.00

Quilt Raffle Ticket (single): $1.00

Quilt Raffle Tickets (book of 6) $5.00

Is this a Gift Membership?:

Yes, Gift Membership

No, not a Gift Membership

Please indicate if this is a gift membership, and enter in the address below of the recipient.

Gift Membership:

If this is a gift membership, please include the name and address of the recipient.

Shipping: *

Please Bill Me

Mail-in Payment, (MCHS, P.O. Box 434, Union, IL 60180)

For Mail-in Payments, Include a your copy of order, and mail to: McHenry County Historical Society, P.O. Box 434, Union, IL 60180

Math question: * 1 + 3 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.