OHBA Membership Application Form

Please print this page and enclose it with your check made payable to OHBA. Mail to:

                
 OHBA Treasurer
 Mr. Joe Charles
 726 Newark-Granville Road
 Granville, OH 43023-1451  

Name:______________________________________________________

Address:____________________________________________________

City:__________________State:_______Zip (9 digit):________________

Phone: (      )                     Email:

 Membership

 Years

Dues

Description
Individual   $10.00 Annual membership includes journal subscription for 1 year.
Family   $15.00 Annual family membership includes journal subscription for 1 year.
Senior/Student   $ 8.00 Seniors are aged 55 and older. Annual membership includes journal subscription for 1 year.
Contributing   $25.00 Includes annual family membership, journal  subscription for 1 year and $10 donation.
Supporting   $40.00 Includes annual family membership, journal  subscription for 1 year and $25 donation.
Lifetime   $250.00 Lifetime membership includes journal subscription.

Total Paid

 $

Select the membership type (circle).    NEW    /     RENEWAL