Personal Membership
Gift Membership

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Day Telephone:
Evening Telephone:
Email:

For family level memberships, please list all children 12 years and younger who are living at the same address if you would like to enroll them in the Museum's Kid's Club.
Name	Month/Year of Birth

Membership Type

New Member
Renewal

Membership	1 Year
Full-Time Students	$15
Individuals	$40
Couples	$50
Family	$60
Supporting	$100
Associate Patron	$250
Patron	$500
Donor Benefactor	$1,000
Foundation Circle	$3,000
Discount for Senior and Active Duty Military	10%

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