Historical Preservation Society of the Upper Keys, Inc.

Post Office Box 1021 ? Tavernier, Florida 33037 ? Phone (305) 852-8348

www.keyshistory.org

Application for Membership, Annual Membership Renewal, and/or Address Change

Name:__________________________________________________________________________________________

Primary Address

Street:___________________________________________________________________________________________

City:______________________________________________ State: _________________ Zip:___________________

Secondary Address (use this address from _______ to _______)

Street:___________________________________________________________________________________________

City:______________________________________________ State: _________________ Zip:___________________

Email Address: _____________________________________________________ Phone:________________________

Annual Dues: Individual $20 Family $25 Supporting $30 Contributing $50 Patron $100

Please mail with your tax deductible check to H.P.S.U.K. at the above address. Thank you!