Suffield Historical Society

Mission Statement: The mission of the Suffield Historical Society is to collect, preserve, and stimulate interest in the history of Suffield and the region and to actively share it. The Society hopes to inspire a sense of community, as well as to provide an understanding and appreciation of Suffield's past.

I/we subscribe to the above mission of the Society.

Please complete this form and mail it with your check to:

Gary Mandirola

1600 North Street

Suffield, CT 06078

Date	________________________
Please circle a title: ( Ms. / Mr. / Mrs. / Mr. and Mrs. )
Name(s)	_________________________________________
Address	_________________________________________
	_________________________________________
Phone *	_________________________________________
Email *	_________________________________________
* Optional

Check any committee(s) that are of interest to you.

___	Collections
___	Development
___	Docents
___	Exhibitions
___	Membership
___	Property
___	Program
___	Special Events
___	Publicity and Marketing

Dues:

Individual	$10.00 yearly
Family	$15.00 yearly
Youth (under 18)	$2.00 yearly
Patron	$25.00 yearly
Donation
Amount Enclosed	________

(The Internal Revenue Service has granted tax exempt status to the Suffield Historical Society.)