Name - Please Print clearly: ______________________________________________________

Membership Number (if applicable): ___________________

Mailing Address: _____________________________________ Telephone: _________________

City, State, Zip: _________________________________________________________________

Email Address: _________________________________________________________________

Enclosed is my donation in the amount of $________________ for

_______________________Montreal Tramways No. 2_______________________
Purpose (i.e. Endowment Fund, General Fund, Carbarns, or a specific car in the collection)

Card/Check #: _____________________________ Exp. Date: ___/______ Verification #: _________
- The verification number is a 3 or 4 digit number usually found on the back towards the right side of the signature box.

Signature: _________________________________________

Please make checks payable to the "New England Electric Railway Historical Society"
Donations to the NEERHS are tax deductable under Section 501(c)(3) of the Internal Revenue Code.

Please mail this completed donation form to:

Seashore Trolley Museum
P.O. Box A
Kennebunkport, ME 04046-1690