Clarksville Region
Historical Society

Application for Membership

I (We) hereby apply for membership in the Clarksville Region Historical Society.

Your information
First and last name as you wish it to appear on your name badge.
First and last name as you wish it to appear on your name badge.
Topics and activities which interest you
Membership and dues

Annual dues level

× $10.00

Single-payment dues level

Additional donations (optional)

I wish to make an additional donation at the following Benefactor Level

Total $0.00

Please make your check payable to Clarksville Region Historical Society and send it to Clarksville Region Historical Society, Managing Organization: Overland Community Foundation, 7000 Rossmore Lane, El Dorado Hills, CA 95762.

Pressing Submit opens your email program with your application addressed to the Society. Press Send there to finish.

Explanation of Terms

The qualifications for membership in the Clarksville Region Historical Society (hereinafter the “Society”) are: (a) An interest in the history of the Clarksville Region, and (b) A desire to further the purposes of the Clarksville Region Historical Society.

The following information refers to items on the Society’s membership application.

Personal Information

Please complete the personal information at the top of the form. This information will be used to record your membership and will be listed in the same manner in the Society’s Membership Roster. The Society will not share the information you furnish us with any unrelated third party.

Interests

The information you provide about those topics and activities in which you have interest will be used to guide the Society in planning its programs. You may also be invited to join a particular committee that is concerned with one of the interests you indicate.

Membership and Dues

Individuals may become regular members by paying dues of $20.00

Other adult individuals in a regular member’s immediate family and living at the same address may become members by paying an additional $10.00 each.

Businesses who join for $100.00 may designate any individual to represent their business at meetings.

Individuals may become Life Members by making a one-time irrevocable donation of $1,000.00, which exempts them from paying dues for the rest of their life. Life Members are designated as Life Members in the Society’s Membership Roster.

Additional Donations

Additional donations from Members are gratefully accepted at any time.

Benefactors

Those members who wish to make a Benefactor Donation to the Society will be recognized as a Benefactor of the Society in the year the donation is made, and will be designated as a Benefactor at the appropriate level in the Society’s Membership Roster in the year following the donation. A member’s cumulative additional donations that reach a level of Benefactor Donation in a calendar year will be treated as one Benefactor Donation.

Tax Deductibility

The Society has applied to the Internal Revenue Service for recognition as a charitable organization under Section 501(c) of the Internal Revenue Code. A similar application has been made to California. When such recognition is granted, any contributions that have been made to the Society since its inception will be deemed to be tax deductible for Federal and California income tax purposes.

The goods or services provided to members and donors to the Society meet the standards for "insubstantial value" set out in Revenue Procedure 90-12, 1990-1 C.B. 471, and Revenue Procedure 92-49, 1992-1 C.B. 987 (as updated); therefore contributions (including membership dues) to the Society are wholly deductible for Federal and California income tax purposes unless otherwise indicated.