BLMA - Membership Form

BLMA
a 501(c)3 non profit organization
Membership Enrollment Form

I want to be an active participant of the Beavertail Lighthouse Museum Association. I have indicated my areas of interest below:

[ ]	Volunteer Museum Attendant
[ ]	Building Maintenance Committee
[ ]	Fund Raising Committee
[ ]	Nominating Committee
[ ]	Archives Committee
[ ]	Museum Clean-up Committee
[ ]	Group Tours Liaison
[ ]	Publicity/Newsletter Committee
[ ]	Oral History Project
[ ]	Holiday Open House
[ ]	Naturalist Program Liaison
[ ]	Other?
	Suggestions:

Please Check one

New Member	[ ]
Renewal	[ ]

Membership period ending 12/31/20___

New Dues Rates:

[ ] Family, Life
[ ] Individual, Life
[ ] Sponsor
[ ] Family
[ ] Individual
[ ] Donation $300.00
$200.00
$100.00
$40.00
$25.00
$_______

Name:
Address:

Phone:
Email:

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Make checks payable to:
BLMA
P. O. Box 83
Jamestown RI 02835
(401) 423-3270

All members will receive a 10% discount at the museum giftshop.