The Eureka Heritage Society

Name: _____________________________________________

Address: ___________________________________________

City, State Zip _______________________________________

Phone: _____________________________________________

E-mail address _______________________________________

Please check your choice:
_____ $20 Individual
_____ $30 Family
_____ $10 Student/Senior
           $75 Sponsor
   _____ Private
   _____ Business
_____ $100 Patron
_____ $500 Benefactor

Enclosed is my check in the amount of $ _______payable to:

The Eureka Heritage Society
PO Box 1354
Eureka, CA 95502

Member Status:
______ New Member
______ Renewal
______ Increase my level of support

To help support historic preservation in Eureka, simply right click on the webpage and select "Print" from the pop up menu.

Fill out the form and mail it to the Society along with a check in your chosen amount.

The Eureka Heritage Society
PO Box 1354
Eureka, CA 95502