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Mail-In Membership 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 become a Member of the Massachusetts Historical Society. 1. Name & Mailing Address Name: Dept./Institution: Address: City/State/Zip: Phone: E-mail: MHS May Send me E-Mail Send as a gift membership to: Name: Dept./Institution: Address: City/State/Zip: Phone: E-mail: Recipient will not be added to our e-mail list without their consent. Please send renewal notices to: Me     Gift Recipient 2. Membership Type New Membership $150 Membership Renewal $150 Fellow $150 (renewal only) Student Member $25 I am making an additional gift to the Society of $ 3. Payment Information  Visa         MasterCard         AMEX         DISCOVER         Check Enclosed (Checks payable to Massachusetts Historical Society) Name on Card:   Credit Card #:   Expiration Date:  (MM/YYYY)   Please mail this form to:    Membership Office    Massachusetts Historical Society    1154 Boylston Street    Boston, MA 02215 Back

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