Membership Form

The Millet and District Historical Society
C/O Millet and District Museum and Exhibit Room
P.O. Box 178 5120-50 Street
Millet, Alberta Canada

T0C 1Z0



Name: ______________________________________________

Address: ___________________________________________


Daytime Phone: (_____)______________________________

E-mail: ____________________________________________

Payment Enclosed by cheque or money order $_____.___

Please send me a tax-deductible receipt for my donation of $ __________ over and above the membership fee.

Please make cheques payable to the Millet and District Historical Society.

Please print this form and mail it to the above address.


This is a FREE Website!

This site contributes to Town of Millet.