Print, complete and mail this Membership form with your payment to the Society.

New or Renew Membership

Name: _____________________________________________________________________

Address: ___________________________________________________________________

City / State / Zip: _____________________________________________________________

Phone: _____________________ Membership Type: ________________________________

Email Address: ______________________________________________________________

If a gift, name of sponsoring member: __________________________________________

I value the work of the Wisconsin Marine Historical Society and I would like to make a tax
deductible contribution to the Society in the Amount of:
$__________________________________________________________________________

VISA or Master Card #: ________________________________________________________

Expiration Date: __________________ Total Amount: ________________________________

Signature: ___________________________________________________________________

Please make check payable to the Wisconsin marine Historical Society