Pickerington - Violet Township Historical Society Membership:

Please print and fill out the application below. Once completed, please mail to:

Pickerington - Violet Township Historical Society
P.O. Box 732
Pickerington, Ohio 43147

Pickerington - Violet Township Historical Society Membership Application

____$7.50 Individual
____$10.00 Family
____$12.50 Supporting		 ____$30.00 Corporate
____$100.00 Lifetime

Name:____________________________________Spouse:_____________________________
Address:_________________________________Children:______________________________
City:_____________________State:_______________Zip:_________:Phone:(____)__________