Apply for Membership

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Online Membership Application 

Thank you for your interest in The Samaritan Society. Please complete the application below and submit. You will be contacted and invited to the next Samaritans meeting in Salem, Massachusetts.

 
     Name
Name:
Email Address:
Mailing Address:
City:
State:
Zip:
Country:
Home Phone:
     Choose Membership Type
Membership Type Annual (cost is $10.00 per year)
Lifetime (cost is $100.00 one time)
      Referrals, if any
Were you referred by any current or prior Samaritan member or friend of the Society? If so please list their name(s) here.
     Questions Comments and Suggestions
Please list any questions, comments or
suggestions about the Society here:
     Payment for Membership


Please bring your membership fee in cash or check to the next Samaritans meeting.
Alternatively you may also mail a check made out to The Samaritan Society for the appropriate fee to:

Treasurer, The Samaritan Society
c/o Pamela Jendrysik
3 Hamilton Street
Salem MA 01970