Chebeague Island Historical Society

Your support is appreciated

	Individual	$10.00
	Family	$20.00
	Contributing	$25.00
	Supporting	$50.00
	Life Membership (per person)	$200.00
	Senior Citizens (65 & over)	$5.00
	additional gift for the following
	Building Fund
	Margaret Bates Book Fund
	Arts & Craft Fund
	Gobb/Small Memorial fund
	I am interested in volunteering

Name ___________________________________________ Address ___________________________________________ Town _______________________ State __________ Zip _____________ Tel ________________________________________ Please make check payable to the Chebeague Island Historical Society. mail to: Chebeague Island Historical Society, RR 1 Box 16, Chebeague Island, ME 04017  Membership dues: Donation to ( _______________) Fund Annual Newsletter ($8, with postage: $______________ $______________ $______________  Total Enclosed: $ ______________ Dues and contributions are tax deductible to the extent provided