Bluegrass Heritage Museum

PRINTABLE MEMBERSHIP APPLICATION

Bluegrass Heritage Museum Membership Opportunities

M _________________________________________________________________________

Address____________________________________________________________________

City ____________________________________ State ________ Zip Code_____________

Phone Number _________________________ Email Address _________________________

    Membership Level:

    $ 15.00 Senior (62 Yrs.+)

    $ 20.00 Individual

    $ 50.00 Family (Spouse & Children)

    $ 250.00 Sustaining

    Founding Memberships    * Founding memberships are a one-time gift.

      $ 100.00 Friend*

    $ 500.00 Sponsor*

    $1,000.00 Patron*

    $2,500.00 Benefactor*

    $5,000.00+ Cornerstone*

    Visa            MasterCard                      Check Enclosed $ ______________

Card Number: __________________________________ Exp. Date: ____/____

Amount: $ __________ Name on Card: _________________________________

Signature: ________________________________________

Bluegrass Heritage Museum
217 South Main Street
Winchester, KY 40391

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