Membership Application

Blue Ridge Chapter

National Railway Historical Society (

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: ___________________