Nicasio Historical Society
P.O. Box 111, Nicasio, Ca 94946



Membership Renewal & Donation Form

Help Make Our Book Project A Reality
With Your Generous, Tax-Deductible Dues/Donation

Name_________________________________________________

Address _______________________________________________

__Member $25 or more         
__Friend  $100 or more           
__Patron  $250 or more
__Benefactor $500 or more
__Special Benefactor  $1000 or more

We sincerely thank you for your continued support!

Please list any special interests or skills

_______________________________________________________

_______________________________________________________

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Press the print icon at the top right of this page to print the form for completion and mailing to the above address.
Thank You