Blue Ridge Chapter
National Railway Historical Society (www.nrhs.com)
Membership Application
Please print legibly. Fill in all applicable data. Sign and date.
Name: __________________________________________________________________
Address: ________________________________________________________________
City: ________________________________ State: ________________ Zip: _________
Home Phone: (___)____________________ Cell Phone:(___)____________________
Work Phone: (___)_____________________ Fax: (___)_______________________
E-mail: _______________________________________________________________
Please provide an emailaddres as currently all National correspondence will only be sent by
email. The Blue Ridge chapternewsletter, Dispatcher, is also sent via email.
You must be a National NRHS member in orderto be a local NRHS member.
2015 Blue Ridge Chapter annual dues - $13.00 ________
2015 NRHS National annual dues - $50.00 ________
NRHS National allows additional family members tobe added to you membership
at $7.00 per person. (The Blue Ridge Chapter has no extra charge for family members).
Please list any additionalfamily members to be added to the National Roster below:
Family Member #1 _______________________ @ $7.00 _______
Family Member #2 _________________________ @ 7.00 _______
Total dues submitted $________
Please make check payable to Blue Ridge Chapter, NRHS
Please mail completed membership application to:
Membership Chairman
Blue Ridge Chapter, NRHS
PO Box 11731
Lynchburg, VA 24506-1731
I agree to abide by the Constitution and By-Laws of the Blue Ridge Chapter and the
National Railway Historical lSociety.
Signature ________________________________________ Date: ___________________
