Please fill out the form below and mail with a check or money order payable to Dutch Island Lighthouse Society and mail to:

Annual dues (dues in all categories and other donations are tax-deductible):

Commissioner: $500

Inspector: $250

Keeper: $100

Assistant Keeper: $50

Family Membership: $25

Individual Membership: $15

Other: _______

Name ______________________________________________________

Address _____________________________________________________

City/State: ___________________________

Zip code: ___________________

Phone: _____________________

Email address: ____________________________

We plan to begin a quarterly newsletter for members soon. We'll keep you updated on our preservation effort!