| New England Electric Railway Historical Society SEASHORE TROLLEY MUSEUM Membership Application |
Yes! I want to enjoy the benefits of Museum membership and support vital perservation and educational work. I wish to enroll as a member.
| [__] Student, | [__] Military, | [__] Disabled |
- |
$30 per year |
| [__] Retired over age 60 | $30 per year | |
[__] Museum Patron | $600 per year |
| [__] Standard Member | $35 per year | [__] Museum Benefactor | $1,200 per year | |
| [__] Sustaining Member | $60 per year | |||
| [__] Contributing Member | $120 per year | [__] Life Member | $900 |
Dues of $500 or greater may be paid in two installments per year, within 90 days of each other.
Enclosed is my membership in the amount of... $___________ Also enclosed is a donation of... $___________ Total............................ $___________ |
| I prefer to pay with: | [__] Check | [__] Charge Card, Type (Please circle): AMEX - MC - VISA - DISC |
Card/Check #: _____________________________ Exp. Date: ___/______ Verification #: _________
- The verification number is a 3 or 4 digit number usually found on the back towards the right side of the signature box.
Signature: _________________________________________
Member Name(s) - Please Print clearly: _____________________________________________
Mailing Address: _____________________________________ Telephone: _________________
City, State, Zip: _________________________________________________________________
Please make checks payable to the "New England Electric Railway Historical Society"
Donations to the NEERHS are tax deductable under Section 501(C)(3) of the Internal Revenue Code.
| Please mail this completed application form to: | Seashore Trolley Museum P.O. Box A Kennebunkport, ME 04046-1690 |
| Thank you for your generous support of the Seashore Trolley Museum. |