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Mail-In Contribution Form
You can fill this form out online, and then print and mail it in, or print out a blank copy to fill in by hand.
Yes, I would like to make a gift to the Massachusetts Historical Society annual Fund.

1. Name & Mailing Address
Name:
Company:
Address:
City/State/Zip:
Phone:
E-mail:

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     In honor of:   In memory of: 
Name:
     Please send a notification to:
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Address:
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Phone:
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Recipient will not be added to our e-mailing list without their consent.


2. Contribution Amount
$2,500
$1,000
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  $100
   $50
Other:

3. Payment Information:


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(Checks payable to Massachusetts Historical Society)
Name on Card:  
Credit Card #:  
Expiration Date:  (MM/YYYY)  


Please mail this form to:

  Development Office
   Massachusetts Historical Society
   1154 Boylston Street
   Boston, MA 02215


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