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Clarke County Historical Society Membership Form
If you do not wish to join online, please print out this form and mail it with your payment to the address below.
Thank you!
Name: ______________________________________________________________________________________________
Mailing Address: ______________________________________________________________________________________
____________________________________________________________________________________________________
Phone Number: _______________________________________________________________________________________
Email Address: ________________________________________________________________________________________
Amount:______________________________________________________________________________________________
Type of Membership: (Please Circle)
FAMILY $40 INDIVIDUAL $30
Please make checks payable to the Clarke County Historical Society and mail to:
Jan South, Treasurer
PO Box 193
Jackson, AL 36545
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