Historic Downtown Millersburg
2016 Enrollment Form
P.O. Box 425
Millersburg, OH 44654
330-674-2412
Historic Downtown Millersburg is 501(c)3 organization so your membership donation is tax deductible.
Level
Bronze
Silver
Gold
Platinum
Corporate Sponsor*
Household
Business
$50
$100
$150
$300
$250
$500
$750
$1,000
$5,000
* Corporate Sponsors' names and logos will be included in all Historic Downtown Millersburg
advertising and on the home page of its website.
MEMBER INFORMATION
Contact Name
Company Name (or NA)
Street Address
City, State & Zip
E-Mail
Phone
Level Subscribed To
Amount Enclosed
I Would Like to Volunteer at HDM Events
Yes:
No:
Please make checks payable to:
Historic Downtown Millersburg
P.O. Box 425
Millersburg, OH 44654
www.historicdowntownmillersburg.com
e-mail: [email protected]