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WALPOLE HISTORICAL SOCIETY
Post Office Box 1724, 33 West Street, 
Walpole MA 02081

Please enter my membership for one year .

DATE_________________

NAME(s)
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ADDRESS
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Street, City, State, ZIP)
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Individual $10.00 Family $15.00 Patron $50.00

Make check payable to: WALPOLE HISTORICAL SOCIETY