BUSINESS Membership Form

Owner(s)*

First NameLast Name
First NameLast Name
Would you like the owner(s)'s names to be included in the Membership Directory?*

Yes! Please include the owner(s)'s name(s).No, I prefer to only have the business' name in the Membership Directory.
Preferred Contact Person

First NameLast Name
Biannual newsletters are sent by mail (print) and email, unless requested otherwise. How would you like to receive your newsletters?*

email only (saves paper and postage)mail (print) onlyboth
Please upload a high-res jpeg or png of your logo that looks good on a white background. (We will display this on our website and in our museum buildings.)

Cancelof

Choose your Membership Level:*

$150 Regular Business (includes listing for 1 business)$200 Multi-Business (includes listing for 2 or more businesses)
Membership Donation amount:*
Please enter amount based on your chosen membership level.
I'd like to make an additional donation to the Ephraim Foundation Heritage Fund in the amount of:
Total Donation:

Total Donation:*

USDDescription

Credit Card

Apple Pay

The Ephraim Historical Foundation is a 501(c)(3) organization. Your contributions are tax-deductible less than the fair market value of any benefits you receive.
Please verify that you are human*
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Business Membership Form