____ Student $5 per year

____ Individual $15 per year

____ Family $20 per year

____ Sustaining $60 per year

____ Corporate $100 per year

____ Life $250 paid once only

Name: _____________________________

Address: ___________________________

___________________________________

City, State & Zip: ___________________________

Phone Number:    ___________________________

Email Address:    ___________________________

 Send this form with your check made payable to:

Towns County Historical Society

P. O. Box 932

Hiawassee, Georgia 30546