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Membership Application for the Frederick A. Cook Society

I would like to join the Society.  Please enroll me in the following membership category:

box.gif (72 bytes) $15 Individual box.gif (72 bytes) $20 Couple box.gif (72 bytes) $25 Family

box.gif (72 bytes)  $4 each:  Poster of 1996 Symposium or Belgica Symposium

(additional up to 4 in one tube, $.50 each)



ADDRESS ____________________________________________
CITY ____________________________________________


ZIP _____________
COUNTRY ____________________________________________


Mail to:

Frederick A. Cook Society
Sullivan County Historical Museum
P.O. Box 247
Hurleyville, NY   12747

Note:  Please send any foreign money orders payable in U.S. dollars.


Return to the "About the Frederick A. Cook Society" page.

Copyright 2005 - The Frederick A. Cook Society