Jewish Historical Society
Membership Application:

Name:________________________________________________________

Address:_______________________________Apt. No.________________

City:__________________________________State:___________________

Telephone:  (home)________________________(cell)__________________

E-Mail:__________________

Membership: _____Student($15)_____Member($36)_____Donor($50)_____Patron($100)

Make checks payable to: Jewish Historical Society of Memphis & the Mid-South.  Mail to:

Jewish Historical Society of Memphis & the Mid-South
Attn: Treasurer
6560 Poplar Ave.
Memphis, TN 38138