Membership Form

Historical Collections Council
Membership Form

To become a member, please complete the following and mail your contact information and membership fee to:

The Historical Collections Council
PO Box 6962
Thousand Oaks, CA 91359

Membership:

	Individual	$125 per year
	Family	$150 per year
	Fellows of the HCC	$500 per year
	Sustainging Fellows (includes spouse or partner)	$1000 per year

Name:

___________________________________________

Address:

___________________________________________

Phone Number:

(_______) __________________

eMail:

________________________________________