CHS Membership Form

Take Your Place In History

Membership Sign-up (R)= Required fields

New Member Gift
Renewal Member ID (If Renewing)

Membership(s) for:

Name:	(R)
Additional Name:
Address:	(R)
City:	(R)
State:	Zip: (R)
Email:
Evening Phone:	( )
Day Phone:	( ) (R)
FAX:	( )

Choose Membership Category (Please select One.)
	Individual	$50
	Family/Group	$65
	Explorer	$125
	Centennial	$250
	Historian	$500
	President's Club	$750
	Heritage Club	$1000
	Associate	$75

Share the Gift of History!
Please complete the following required fields (R) for gift membership only:

Gift From:
Name:	(R)
Member ID:
Address:	(R)
City:	(R)
State:	Zip: (R)
Email:
Evening Phone:	( )
Day Phone:	( ) (R)

Clicking "Create form" will create a printable form that you may send, along with your check or credit card information, to the Colorado Historical Society, 1300 Broadway, Denver CO 80203.