| MEMBERSHIP APPLICATION FED ID # 92-0162384 Tax Deductible Donation |
TITLE (Prof / Dr. / Mr. / Mrs. / Ms) __________
FIRST NAME ___________________ LAST NAME ________________________
INSTITUTION ______________________________________________________
MAILING ADDRESS _________________________________________________
___________________________________________________________________
ZIP-POSTAL CODE __________________ COUNTRY ___________________
TEL _________________________ FAX _________________________
E-MAIL ______________________________________________________
TYPE OF MEMBERSHIP_______________________________________
MEMBERSHIP CLASSIFICATION
SPONSOR...............$5000/yr.
CORPORATE............$1000/yr.
BENEFACTOR..........$500/yr.
PATRON.................$250/yr.
LIFE......................$1000/yr (2/$500 or 5/$200 or 10/$100)
FAMILY..................$75/yr.
INDIVIDUAL............$25/yr.
STUDENT...........$5/yr.
PAYMENT: Enclose a Check
or Money Order payable to the Museum of the Aleutians with this form.
For your convenience, we do take VISA or MasterCard. Please provide the information
below,
and indicate type of card.
WE DO NOT HAVE A SECURE SERVER PLEASE MAIL or FAX FORMS.
VISA-MASTERCARD #_______________________________________________________
EXP. DATE___________ SIGNATURE__________________________________________
MAIL TO:
MUSEUM OF THE ALEUTIANS
MEMBERSHIP DEPARTMENT
P.O. BOX 648
UNALASKA, AK
99685-0648
Tax
Deductible Organization:
The Museum of the Aleutians is a private, non-profit corporation exempt from
Federal Income Tax under
501(a) of the Internal Revenue Code as an organization described in section
501(c)(3). As a result of this
determination, donations, in-kind services, and Museum memberships are U.S.
tax-deductible.
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All rights reserved. Revised:November 10, 2006