Print and complete this page or download the PDF version here.

 Clearwater Historical Society Membership Registration Form 

Choose one of the following categories:

Student          $ 5                                         Corporate      $ 150

Individual       $ 20                                      Life                 $ 250

Family             $ 35                                      Patron            $ 500

                                                                      Benefactor    $ 1000 


*Dues are payable annually on November 1. All contributions are tax deductible.*

Print this page, complete the following information, then mail this page and your check to:
Clearwater Historical Society
P.O.Box 175
Clearwater, FL 33757



City___________________________ State______ Zip__________________

Email Address______________________________________________________

Phone(_____) __________________

The only membership requirement is your interest!

_____I would enjoy serving on a committee.
_____I would be interested in serving on the maintenance committee.
_____I would be glad to be a docent on Saturdays.
_____It would be a great honor to be on the Board of Directors of the Clearwater Historical Society!
_____I have family pictures, papers, etc., that I will give or loan to the Society.