Print out this page, fill it out the application, and mail it to:
Lincoln Highway Association — Treasurer
P.O. Box 5192
Fairlawn, OH 44334-0192
Date: ____________________ Annual membership is from date of enrollment.
( ) New Membership ( ) Renewal
Membership Categories:
|
( ) Student:* $25 ( ) Individual: $45 ( ) Family: $60 |
( ) Libraries, museums & historical societies: $45 ( ) Local, state, and county governments: $45 ( ) Supporting: $75 |
( ) Patron: $150 ( ) Business: $75 |
( ) Corporate: $150 ( ) Life: $1000 and up |
* Students: include copy of front and back of student ID card
State Affiliation
| Members who live in Lincoln Highway states are automatically members of that state's chapter. Dues for additional chapter memberships are $9.00 per year per state. Check the appropriate box. |
[ ] NY [ ] IN [ ] CO |
[ ] NJ [ ] IL [ ] UT |
[ ] PA [ ] IA [ ] NV |
[ ] WV [ ] NE [ ] CA |
[ ] OH [ ] WY |
If you would like to serve on a committee, which one?
|
[ ] Awards [ ] Bylaws [ ] Conference |
[ ] Fund Raising [ ] Government Relations [ ] Highway Preservation & Interpretive Sites |
[ ] Historic & Contemporary Markers [ ] Historic Resources [ ] Marketing |
[ ] Nominating [ ] Public Relations [ ] Headquarters |
Please Print
|
|
||||||||||||||||||||||||||||||||||||||||||
What do/did you do for a living? _____________________________________
The Lincoln Highway Association is exclusively charitable and educational, within the interpretation of Section 501(c)(3) of the Internal Revenue Code.
Payment Method:
| ( ) Check (payable to Lincoln Highway Association) |
Credit card: ( ) Visa ( ) MasterCard ( ) Discover
|