New Member
Renewing Member
Select Membership Level
----------------------------
$45 - Student/Teacher
$55 - Senior (62+ yrs)
$55 - Library/Nonprofit/Historical Scoiety
$60 - Basic Membership
$75 - Plus Membership
$125 - Friend
$250 - Contributor
$500 - Benefactor
$1,000 - Silver Circle
$2,500 - Gold Circle
$5,000 Platinum Circle
$10,000 Diamond Circle
Membership renewals should be sent to:
----------------------------
Gift Recipient
Gift Giver
First Name
Last Name
Address
City
State
Mailing Zip
CC Billing Zip *if different from mailing zip
Country
E-mail
Phone
Gift Recipient Name
Gift Recipient Address
Gift Recipient City
Gift Recipient State
Gift Recipient Zip
Gift Recipient E-mail
Gift Recipient Phone
*
I want to make a tax deductible contribution in addition to membership:
$
*
International members, please add $10 to your membership fee.
$
TOTAL CHARGE
$
Credit Card Number
Expiration Date
Security Code
All contributions above $40 are tax-deductible to the extent allowed by law