North Clark Historical Museum

Membership

Print out this Membership Application Form

Name _________________________________________

Address _____________________________________

City & Zip ___________________________________

Phone ______________________________________

Email______________________________________

( ) Regular - $10	( ) Supporting - $50
( ) Contributing - $25	( ) Patron - $100
( ) Benefactor - $500	( ) Honored Donor - $1,000 +
( ) Donation $___________

Designate: ( ) Individual. ( ) Family (those living in the same household).
( ) Business. ( ) Organization.

Annual dues renewable in July. Members receive museum newsletter. Regular meetings are held at the museum, 2nd and 4th Thursdays at 7 p.m. (Meetings are not scheduled for holidays.) Phone 360.247.5800

Make checks payable to North Clark Historical Museum and mail to:
North Clark Historical Museum
P.O. Box 296
Amboy, WA 98601