Member Application

I want to be part of the Furnace Town Living Heritage Museum through a membership in the Foundation under the following category.  Payment is enclosed. Questions? Want to volunteer? Call 410-632-2032.

Individual ($20)
     Member only, 2 annual guest passes

Family ($35)
    Member and family members residing with member  plus four guest passes

Collier ($50)
    Individual/family as above, plus six annual guest passes

Ironmaster ($75)
    Individual/family as above, plus six annual guest passes

Corporate ($125)
     Designated officer of the corporation and his/her family plus six annual guest passes

Supporter ($125)
    Individual/family as above, plus six annual guest passes

 
Name


Company


Address


Email


Telephone
<Format:xxx-xxx-xxxx>

Method of Payment

Check Visa
Cash MasterCard

    
Credit Card No.              Expiration
                                        Date

____________________________
Signature

    Print Form

Mail Printed Form and Payment to:

Furnace Town Heritage Foundation
P. O. Box 207
Snow Hill, MD 21863

Thanks for your support!

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