MAXTON HISTORICAL SOCIETY

Membership (CIRCLE ONE)                 

                                  Maxtonian                 Loyal Maxtonian             Maxton Patron

Single                          $15                                  $25                                 $50

Couple                        $20                                  $30                                  $75

NAME  ______________________________________________________

STREET OR  P. O. BOX____________________________________________________

CITY, STATE, ZIP ___________________________________________________

REMIT TO

Maxton Historical Society

P.O. Box 55

Maxton, NC 28364