Membership Form

CENTER FOR HOLOCAUST STUDIES MEMBERSHIP FORM

Please make your check payable to The Center for Holocaust Studies.
When you have finished filling out the form, print it and mail it with your check to
The Center for Holocaust Studies, 765 Newman Springs Road, Lincroft, NJ 07738.

Please fill in the information indicated below.
Name:
Street:
City:
State:
Zip:
Phone:

Please select your membership.

One Year (July 1 - June 30)
General membership @ $18.00
Contributing membership @ $36.00
Sustaining membership @ $100.00
Benefactor membership @ $360.00
Corporate membership @ $1000.00

Lifetime Membership
Lifetime Membership @ $500.00