Ticknor Society 2017 Annual Membership Form

Membership in The Ticknor Society is open to anyone who loves and reads books. Your continued support is what keeps us going strong. Annual dues are $35 per individual and cover the calendar year. Please print this form and either include a check made out to The Ticknor Society, or pay us using PayPal: see link below. You don't need a PayPal account to use PayPal. Whether paying by check or by PayPal, please send this form to us at: The Ticknor Society, c/o Christopher Carter, 1910 Dorchester Avenue, #504, Boston, MA 02124-3780.

For further information on your membership status, write to the address above, or email Elizabeth Roscio at eroscio@gmail.com, or call her at 703-967-6882.

THIS FORM CANNOT BE SUBMITTED ONLINE. PLEASE PRINT CLEARLY & MAIL IN

Date:
Membership year is January 1 - December 31                                     

You can now pay your Ticknor dues using PayPal! Just click the button below (No PayPal account required):

Dues menu

Please check all that apply:

I want to support the Ticknor Society. Here is my Additional Tax Deductible Contribution:   

$ _______________

My contact information has changed

Please check one:

New member $35  
Renewal $35 
Joint $70 (2 at same location)
Joint Renewal $70

Name:

Address:

City:       State:    Zip:
Preferred phone   home   work   cell :
Email:       Please circle your preferred communication:    Email     Print   (for those who do not use email)

Bibliophilic interest(s):

Comments and suggestions:

The Ticknor Society is a tax exempt public charity under section 501 (C) (3) of the Internal Revenue Code, and contributions, including membership dues, to the Society are deductible under section 170 of the Code.