South Carolina Historical Association 
Institutional Membership Application 

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DEPARTMENT CHAIRPERSON [PLEASE PRINT]         

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INSTITUTION NAME

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ADDRESS - Line 1
                     

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ADDRESS - Line 2
                                                                                      
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CITY, STATE, & ZIP

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PHONE NUMBER // FAX NUMBER

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E-MAIL ADDRESS

 

   INSTITUTION BILLING METHOD:

          ENCLOSED ($25) ______

          PLEASE BILL ______

   Please complete this form and return it with your payment to:


Rodger Stroup
South Carolina Archives & History Center
8301 Parklane Road
Columbia, SC 29223-4905