MEMBER INFORMATION

qNew member qRenewal

qMr. qMs. qMrs. qDr. qOther_______________

Name: ______________________________________________________________

Name for additional card (family level and higher):______________________________

Address: ____________________________________________________________
City, State, Zip: _______________________________________________________
Phone: ______________________ Email: _____________________

Enclosed is my company’s matching gift form. 
Company name:_______________________________________________________

CATEGORY (please choose one)

Enclosed is my check for $_____ made payable to the SC Archives & History Foundation

Please charge $______ to my q Mastercard   q Visa  q American Express

Name on Card:    ____________________________
Account Number: ____________________________
Expiration Date:  _____________________________

Signature: __________________________________

Please allow 2-3 weeks delivery for your membership packet. For more information please call Grace Salter at (803) 896-0339 or email gsalter@scdah.sc.gov