HIGHLAND HISTORICAL SOCIETY MEMBERSHIP APPLICATION NAME ________________________________________________ ADDRESS ________________________________________________ CITY ________________ STATE ______ ZIP ________ PHONE ________________ (optional) Membership Status: (check one) Individual ($5.00) _____ Contributing ($8.00) _____ Business ($10.00) _____ Sustaining ($25.00) _____ Membership fees and donations should be sent to: Highland Historical Society c/o Bank of Highland 2611 Highway Avenue Highland, IN 46322