(To print this form, click the "Print" button on your Web Browser)

- Membership Application -
The Marine Historical Society of Detroit
A Non-Profit Organization

By Mail:
Please make your check for $30.00 payable in U.S. funds to:

The Marine Historical Society of Detroit

Mail to:
Robert T. Pocotte, Treasurer
Department W
606 Laurel Ave.
Port Clinton, Ohio 43452


Name: ______________________________________________

Address: ____________________________________________

City: _______________________________________________

State/Province: _____________________________

Postal Code: _______________________________

Country:___________________________________

Amount Enclosed: ___________________________

Area of Interest:____________________________________________________________
(To be used in planning future issues of the Historian)

__  I am sending this Membership as a Gift    (click here to print out a Gift Membership Card)