AFTON HISTORICAL SOCIETY MEMBERSHIP FORM Please print out and complete this form to join, renew or purchase a gift of membership. Mail to: Afton Historical Society, P.O. Box 178, Afton, MN 55001 Name(s): _____________________________________________________ Address: _____________________________________________________ City/State/Zip: _____________________________________________________ Daytime phone: ____________________ This membership is: ____New ____Renewing ____Gift membership* Please select a membership category: ____$5 Senior Individual (age 65+)/Student ____$15 Individual (benefits for one adult) ____$25 Family ____$26-50 Associate ____$51 - $99 Supporting ____ $100+ Patron Payment Enclosed is my check for $______ payable to the Afton Historical Society Please check any of the following: ____Please send information about volunteer opportunities ____Please withhold my/our name from mailing list exchanges* *Our policy is not to provide any mailing list information. Benefits: Newsletter and Event mailing, 10% discount on items for sale, Free research. Membership dues may qualify for a matching gift from your employer. Please contact your company for more information. Questions? Call 651-436-3500. *To give a gift of membership, please also complete the information below: Gift recipient's name(s) ______________________________________________ Gift recipient's address _____________________________________________ Gift recipient's city/state/zip _________________________________________ Gift recipient's daytime phone: _________________________________________ First renewal notice will be sent to the gift giver. Thank you for your support of the Afton Historical Society!