The Society is a non-profit organization maintained by volunteers, and is funded solely by gifts, bequest, and membership dues. If you share our interests, we invite you to join us by printing and filling out the application below and returning it to us with a check made payable to: IAHS of CT.

Dues categories:  
___ Individual ($15)
___ Family ($25)

Total amount enclosed: $ ____________

Donations: If you do not wish to become a member at this time, but would like to make a tax deductible (within the provisions of federal tax laws) donation, please indicate the name of the person in whose honor or memory you wish the donation to be made:

Donation: $_________ | Name:

 ______________________________________

MEMBERSHIP APPLICATION  
(January 1 to December 31)


NAME


ADDRESS


CITY / STATE / ZIP


TELEPHONE / EMAIL


MAIL TO:

IAHS OF CT
P.O BOX 126371
EAST HAVEN, CT 06512