MEMBERSHIP FORM

We invite you to become a member. Free gifts are available when joining at several membership levels.  Everyone receives a 10% discount in our Lighthouse Gift Shop.  Regular Updates when your e-mail address is filled in.  When finished print form and mail to:

CHARLOTTE-GENESEE LIGHTHOUSE HISTORICAL SOCIETY
70 LIGHTHOUSE STREET
ROCHESTER, NEW YORK 14612-4710

Senior Citizen /Student                                                   $ 8.00

Individual                                                                     $ 15.00

Family                                                                          $ 25.00

Contributing                                                  $ 30.00 to $49.00

Supporting(Free T-shirt)                               $ 50.00 to $99.00

Patron(Free Sweatshirt)                                 $ 100.00 to $499

Curator(Free Mounted photo)                   $ 500.00 to $999.00

Lighthouse Keeper                                          $ 1,000.00 & up

(T-Shirt, Sweatshirt, & Mounted Photo)               

Business                                                                        $ 25.00

Business                                                             $ 50.00 & up* 


(*1-year listing in The Genesee Beacon Newsletter)

Check one:          NEW             RENEWAL 

Name: 

No. & Street:   

City:  

State:    Zip Code:   

E-mail Address:  (E-mail address will allow you to receive updated news )

Home Phone:      -  
  
(Print Form & Mail to above address)