BRHS Membership Renewal Form

Please print this form on your printer and mail to address below.
Hint - Fill out the form on your computer, then print it.
 
BRHS Membership Number
Renew next year's membership as:
Regular: One year $30
 (Entitled to one vote, all activities,and all publications during the year.)
Family: One year $30
 (Same as Regular plus all members of family may participate in contests)
Subscription: One year $30
 (For libraries, museums, societies, and other groups. Entitled to all publications but is not allowed to vote in business matters.)
Sustaining: One year - $60 or more*
 *amount above $20 is tax deductible
For mail outside of US add: Surface - $6.00
Airmail - $20.00
Total enclosed $
Fill out the following only if changed:
Name
Address
City
State
ZIP
Phone Number
E-mail Address

Make check or money order (DO NOT SEND CASH!) payable to: BRHS then mail to:

Burlington Route Historical Society
Membership Renewal Services, Dept. I
P. O. Box 456
La Grange, IL 60525