Keansburg Historical Society Online Membership Application

Name:    _____________________________________________

Address:  ____________________________________________

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Telephone:    _________________________________________

E-mail address:    _______________________________________

Would you  be interested in volunteering at the museum?

    Yes    No  (circle one)

Would you be interested in receiving e-mail notices of society news and programs?

    Yes    No  (circle one)

Comments:  _____________________________________________________________

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Please print and send this form and a check or money order for $12.00 dues for one year to:

The Keansburg Historical Society
c/o Lorraine Kryscnski, Treasurer
29 Beacon Blvd.
Keansburg, NJ 07734