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Alexandria Society for the Preservation of Black Heritage Inc.
Membership Application

Please print and complete this form and mail it with a check or money order payable to: The Alexandria Society for the Preservation of Black Heritage, Inc. (ASPBH. Inc.) P.O. Box 3527 Alexandria, Virginia 22302
Membership Term (Select One)
Fiscal year	1 January				31 December

Membership Type (Select One)
Organization / Corporation $250.00 per year	Family / Couple $35.00 per year			Adult $20.00 per year	Youth (under 18) $5.00 per year

Member Information
Name:
Family Member(s): (if applicable)
Address:
City:		State:		Zip Code:
Telephone:

Interested in Volunteering? (Select One)
YES			NO

Alexandria Black History Museum
902 Wythe Street
Alexandria, Virginia 22314
Phone: 703.746.4356
Fax: 703.706.3999
Email

Museum Hours:
Tuesday - Saturday
10 a.m. to 4 p.m.
Admission - $2.00

Office Hours:
Tuesday - Saturday
9 a.m. to 5 p.m.
by appointment only