Membership Form

Sign up to be a member of the Muskoka Lakes Museum by completing the form below and printing it. This form can be mailed with a cheque or credit card information orfaxed with credit card information to:

Muskoka Lakes Museum * P.O. Box 432 * Port Carling, ON * P0B 1J0
 

First Name:

Last Name:

Address:

Town/City: Province:

Postal Code:

Telephone: Email:

I would like to become a:

Senior Member ($20 per year)

Supporter* ($100+ per year)

Individual Member ($30 per year)

Sponsor* ($200+ per year)

Family Member ($50 per year)

Curator's Circle* ($500+ per year)
 

Benefactor* ($1,000+ per year)

* Supporters, Sponsors, Curator's Circle and Benefactor's will receive their tax receipt in February 2006.

I will pay my membership fees by:

Credit Card Number: Expiry Date: (YYYY/MM/DD)

Name on Card:

Signature:

______________________________________________________________

To Print the Form please use File>Print.