Society/Museum Membership Form

Society/Museum Membership Form
Lincoln County Historical Society

Yearly Membership

Individual (Annual membership: $30.00)

Family/Couple (Annual membership: $50.00)
Membership includes Parents or Gaurdians and children 18 years old and under.

Contributing (Annual membership: $75.00)

Supporting (Annual membership: $100.00)

Sustaining (Annual membership: $200.00)

One time Membership

Lifetime- Individual (membership: $300.00)

Lifetime- Couple (membership: $500.00)

Patron (membership: $600.00)
Member contact information
Name*

First NameLast Name
Name for second membership card (applicable for Family/Couple, Contributing, Supporting, Sustaining, or Lifetime-couple membership levels)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email address*
example@example.com
Duration of membership

Lincoln County Historical Society memberships are based on the calendar year.

Membership Payment*

Individual

$30.00 Quantity

Family or Couple

$50.00 Quantity

Contributing

$75.00 Quantity

Supporting

$100.00 Quantity

Sustaining

$200.00 Quantity

Lifetime (Individual)

$300.00 Quantity

Lifetime (Couple)

$500.00 Quantity

Patron

$600.00 Quantity

Total

$0.00

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay