![]()
MEMBERSHIP
____ New Membership
____ Renewal
____ Gift Membership
VALUE
____ Individual: $40 per year
____ Household: $55 per year (2 adults and children under 18)
____ Contributing: $100 per year
____ Supporting: $250 per year
____ Sustaining: $500 per year
____ Founder: $1000 per year
Name _______________________________________________________
Address ______________________________________________________
City _________________________________ State _________________ Country _________
Postal Code (Zip) ______________________
Telephone (day) __________________________ (evening) ____________________________
____ In addition to my membership indicated above, I am also enclosing a tax deductible
donation of $_____________
SEND A GIFT MEMBERSHIP TO:
Name _______________________________________________________
Address ______________________________________________________
City _________________________________ State _________________ Country _________
Postal Code (Zip) ______________________
Join now. You can include payment by check or money order, or use the credit card form below.
Please print out the mail-in enrollment form, fill it in, and send it via regular mail.Form of payment:
____ Payment Enclosed
____ Mastercard ____Visa ____Discover ____American Express
Expiration Date ____________________________
Card # ___________________________________
Signature _________________________________
Do you want to know more about membership or services offered by the Society?
- Call 402-435-3535
Call toll-free 1-888-515-3535
FAX 402-435-3986 Nebraska State Historical Society Foundation
Attn: Membership Coordinator
Kinman-Oldfield Suite
128 N 13th Street #1010
Lincoln, NE 68508-1565
Trouble printing? Download a Membership Application Form in PDF format.