Printable Membership Form


January 1 – December 31, 2018        
Revised 12/01/2015

Check One: Membership Type: Amount
Senior / Student $20.00
Individual $25.00
Family $30.00
Supporting $100.00
Lifetime $1,000.00
Organization $100.00
Professional/Business $125.00
Corporate $250.00
Additional Donation $
Total Enclosed $
If your firm matches contributions,
please attach the signed company form.  KHS is a 501(c)(3).

Checks to be made payable and mailed to:

Kirkland Heritage Society
203 Market Street,
Lower Level
Kirkland, WA  98033

Resource
Center Phone:  (425) 827-3446

Email: Help@kirklandheritage.org

Name____________________________________

Address__________________________________

City_____________________State____Zip_____
Phone _____________________________ Email_______________________________________