Culinary Historians of Chicago (CHC)
Membership Application
You may fill-in the blanks and then print OR print a blank form and fill-in manually.

Name (member one):
Name (member two):

Address:
City:           State:    ZIP:
Phone:       (Eve):    Fax:
E-mail:       Website URL:

Membership Type: Individual $36.00 Couple $60.00 Student $24.00

Note: If you want a membership card mailed to you, please include a stamped, self-addressed envelope with your membership fee.

I would like to receive notification of upcoming events via e-mail. Yes No

I would like to volunteer to help with committee work. Yes No

Are you currently a member of ChicaGourmets!? Yes No

Areas of interest or comments:

(will erase all entries)

PRINT THIS FORM AND MAIL, WITH CHECK PAYABLE TO:
Culinary Historians of Chicago
c/o Marliss Levin - Gil Levy
848 Timber Hill
Highland Park, IL 60035

For non-members to attend a lecture hosted by the Culinary Historians of Chicago we do charge Adults $10.00 and students with current ID $5.00, unless otherwise stated. Members of ChicaGourmets! have a discounted fee of $5.00. Fees are collected at the door.

For Office Use Only: Cash: ___________ Check #___________ Date: _____________ Initials: ________ Year: ____________