|New England Electric Railway Historical Society
SEASHORE TROLLEY MUSEUM
Yes! I want to enjoy the benefits of Museum membership and support vital perservation and educational work. I wish to enroll as a member.
|[__] Student,||[__] Military,||
|$30 per year|
|[__] APTA Member||$25 intro. rate||[__] Contributing Member||$120 per year|
|[__] Retired over age 60||$30 per year||[__] Museum Patron||$600 per year|
|[__] Standard Member||$35 per year||[__] Museum Benefactor||$1,200 per year|
|[__] Sustaining Member||$60 per year||[__] Life Member||$900|
Dues of $500 or greater may be paid in two installments per year, within 90 days of each other.
Enclosed is my membership in the amount of... $___________
Also enclosed is a donation of... $___________
|I prefer to pay with:||[__] Check||[__] Charge Card, Type (Please circle): AMEX - MC - VISA - DISC|
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.
Member Name(s) - Please Print clearly: _____________________________________________
Mailing Address: _____________________________________ Telephone: _________________
City, State, Zip: _________________________________________________________________
Email Address: _________________________________________________________________
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 application form to:||
Seashore Trolley Museum
P.O. Box A
Kennebunkport, ME 04046-1690
|Thank you for your generous support of the Seashore Trolley Museum.|