Indicate Membership Level:
Student $10.00 Family $50.00
Model Railroad Club $20.00 Lifetime $250.00
Individual $30.00 Corporate $500.00
Enclosed please find payment of $

Name:

Spouse's Name:

Street Address:

City:

State:

Zip:

Please make check payable to: Historic Lake Wales Society

Interested in volunteer opportunities

Print and complete form, then mail with payment to:
Historic Lake Wales Society
c/o The Depot
325 S. Scenic Highway
Lake Wales, FL 33853

Back