Name:___________________________________________________________________
Address:_________________________________________________________________
City:__________________________________State:___________ZIP:____________
Telephone :( ____)_________________
Memberships due April 1st for 1 year to March 31st .
Membership #:________________________Check appropriate spaces you are or wish to be and enclose remittance.
__New Member __Renewal __ Change of Information __ Reinstate
| ONE YEAR MEMBERSHIP | LIFE MEMBERSHIP |
| __Age 0 - 60 - $20.00 | __Life Member - $350.00 |
| __Age over 60 - $15.00 | __Golden Life - $500.00 ($350.00 due 1st year, balance in 5 yrs.) |
| __Family - $30.00 (parent/s & children under 18) | |
__Sustaining - $75.00 |
$ __________Membership Dues
$ __________Extra Donations
$ __________Total Enclosed *
*All payments in US Funds **Please inquire about additional fees for postage outside continental United States.
Check items below that
may interest you as a volunteer.
__Rolling Stock __Cleaning Buildings or Grounds
__Museum
Attendant
__Model Railroading
__Gift Shop
Salesperson
__Building Maintenance
__Mailing -
Trips/Brochures
__Newsletter Articles
__Landscaping __Displays
__Museum Tour
Guides
__Committee Work
__Other________________________________________________________
_________________________________________________________
_________________________________________________________
Volunteers are always welcome and needed. Thank you.
Mad River & NKP Railroad Society, Inc.
ATTN:Membership Committee
233 York Street
Bellevue, Ohio 44811-1377
|
Office Use Only Date ________________ $ _______________ Check # _____________ Cash _______________ Pd to Yr _____________ Treas _________________ Compr ________________ Secy __________________ |