Membership Application

Name________________________________________________________________

Spouse_______________________________________________________________

Address_______________________________________________________________

Phone (Home)_________________ Phone (Work)_________________

Email address__________________________________________________________

____New Membership _____ Renewal _____ Gift Membership

_____ $20 Annual Student

_____ $30 Annual Individual

_____ $40 Annual Family

_____ $100 Annual Non-Profit

_____ $200 Annual Commercial Institution *Includes a business card size (2 X 3.5”) ads in each quarterly newsletter. Please include camera ready art

Make check payable and mail to:

The Susquehanna Museum

P. O. Box 253

Havre de Grace, MD 21078

I’m interested in volunteering in the following areas:

___ school tours

___ gift shop

___ building & grounds

___ lock restoration

___ environmental education

___ Teas

___ Fund-raising

___ Exhibits

___ Computer work

___ photography

___ Event Planning

___ Newsletter

___ Candlelight Tour

___ Christmas Boutique

___ Spirit Walk

___ Educational Events