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!