Alexandria, VA-Alexandria Black History Museum - Alexandria Society for the Preservation of Black Heritage Membership Application

Alexandria Society for the Preservation of Black Heritage Membership Application

Please print and complete this form and mail it with a check or money order payable to: The Alexandria Society for the Preservation of Black Heritage, Inc. (ASPBH. Inc.) P.O. Box 3527 Alexandria, Virginia 22302
Membership Term (Select One)
Fiscal year	1 January				31 December

Membership Type (Select One)
Organization $25.00 per year	Adult $20.00 per year				Youth (under 18) $5.00 per year

Member Information
Name:
Address:
City:		State:		Zip Code:
Telephone:

Interested in Volunteering? (Select One)
YES			NO