Oakville Historical Society

Name *

First Name

Last Name

Email *

Phone

Area Code

Phone Number

Address

Street Address

City

State / Province / Region

Zip / Postal Code

Country

(Address is required for charitable tax receipt if choosing a Supporting Membership)

Additional person:

Is there a second person in your household who will be part of your membership? Please provide their name and email:

Additional Name

First Name

Last Name

Additional Email

MEMBERSHIP LEVEL

Please choose your membership level:

General

General SUPPORTING

(Includes $25 tax receipt)

Senior (Aged 60+)

Senior (Aged 60+) SUPPORTING

(Includes $30 tax receipt)

Total *

$0.00

Payment: Credit Card *

Cardholder Name

VISA

MasterCard

American Express

Card Number

Expiration Date

Security Code

Thank you for your support!

We are delighted to have you join us! Thank you for helping us to preserve, protect and promote Oakville's heritage.

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