I hereby apply for membership in the Placer County Historical
Society
and enclose $________, annual dues for the year ______ or $________ for a Life
Membership.
Mailing Address (Please Print)
NAME (Include all names for family membership)
NUMBER STREET
CITY or TOWN STATE ZIP
( ) _____________________________
TELEPHONE
Please print, complete and mail with remittance to
PLACER COUNTY HISTORICAL SOCIETY
P.O. Box 5643
Auburn, California 95604
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