Existing Member Short-Form Renewal or Gift - Dutchess County Historical Society

For renewing members, or anyone for whom we already have all your contact information, in addition to your name you need only provide an update to anything that has changed in terms of contact information.

Please Confirm Name(s)

First

Last

First

Last

Please note any recent changes in contact information, if any, in terms of regular mail and email addresses, telephone, etc.

Choose Your Membership Level

Additional Donation

Total

$ 0.00

Please indicate how you will pay

I will mail a check payable to DCHS to DCHS ~ PO BOX 88 ~ Poughkeepsie NY 12602
I will pay by credit card below

Indicate type of Credit Card

Visa
Mastercard
American Express
Discover

Credit Card

Card Number

Security Code

Name on Card

Expiration/

Credit Card Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Yes, please mail me a printed Membership Card

You may make any comments here , thank you!

Phone

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