San Juan Historical Society Membership Application


By becoming a member of the San Juan Historical Society you will help preserve the history and rare artifacts that are part of the heritage of Pagosa Springs and the San Juans. Membership is from May 1st through April 30th. Members are entitled to a 10% discount on books and items from the gift shop and free admission.


Name:______________________________________________________Date:________

Company:_______________________________________________________________

Address:________________________________________________________________

City:______________________________State:_________________Zip Code:________

Phone:________________________email:_____________________________________

Membership Levels:

_____ Individual $15.00                _____ Family $25.00                _____ Senior (60) $10.00

_____ Contributing $50.00            _____ Patron $125.00              _____ Benefactor $500.00

Corporation/Business:

_____ $125.00               _____ $250.00               _____$500.00               _____ $1000.00

Donor:

_____ $1500.00                          _____ $2000.00                          _____ Other

I would like to make an additional donation of $___________________________________

_____In memory of _______________________________________________________

_____In honor of_________________________________________________________

Mail to:
San Juan Historical Society
P. O. Box 1711
Pagosa Springs, CO 81147

Thank you for your support.