Membership Application

    q $50 Individual
    q $60 Family
    q $100 Sustaining
    q $250 Patron
    q $500 Sponsor
    q $1000 Corporate
    q $35 Young Associate

A senior citizen (65 and older) discount of 10% may be applied to any level of membership

Please print

Please call 713.655.1912, or mail this form today.

Mail to:
The Heritage Society
1100 Bagby Street
Houston, TX 77002-2504

Name: Mr./Mrs./Ms./Miss

Address

City/State/Zip

Telephone (Home)                                                         (Office)

email address

Please make check payable to THS. Complete the following to charge your membership:

    q American Express
    q MasterCard
    q Visa

Charge account number

Expiration date

Print name as it appears on credit card

Signature

The Heritage Society is a 501 (c)(3) organization. Membership dues are tax deductible to the extent allowed by law.