317 A. Philip Randolph Blvd.
Jacksonville, FL 32202-2217
Email: info@jaxhistory.com
Phone: (904) 665-0064 -- Fax (904)665-0069

Online Membership Form

For your convenience, you can become a member of the Jacksonville Historical Society by filling out this form.  Click on the "Submit Your Membership Form" button at the bottom, and you will instantly be a member.
You can also join the JHS by mail.  Click here to print a Membership Form for mailing.

1. Enter Your  Information:
Items marked with an asterisk* are required information.
Please provide information for our records. 

*Name 
*E-mail
Home Phone      
Work Phone       
*Mailing Address
                *City   
                *State  *Zip Code

2. Select Your Membership Level:
    Heritage $5,000 or more $     Sponsor   $250
    Patron   $1,000  or more $     Friend     $100
    Sustaining $500     Family    $50
    Corporate $250     Single     $35
In addition, I want to contribute to:
    St. Andrews Operations   $    Jacksonville Historical Center $
    JHS Archives                   $     Merrill House Restoration     $
Contributions are tax-deductable  TOTAL AMOUNT         =     $

3. Select Your Credit Card Payment Type:
      *Card Number  *Expiration Date
*Credit Card Billing Address - Required for Credit Card Use
 Check here if billing address is the same as the address above
Billing Address   
                  City   
               State     Zip Code

4. Additional Information:

  Your areas of special interest (optional):


  • Note: The total amount will be billed to your credit card, and you will receive a confirmation of your order and total charges by e-mail within 48 hours.

    		•

    Return to JHS Home Page       Back to the top