Membership Form

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Michigan Transit Museum - Application for Membership
Associate ($20/year) Active ($30/year) Life ($1000 or more)
(Note: All memberships run from Jan.1st through Dec. 31st)

Name:___________________________ Address:_____________________________

City:______________ State:____ Zip:_______ Phone:_____________ Age:___

Occupation:____________________Special interests:_____________________

E-mail address:_______________________May we publish e-mail addr:_____

Office use only
START DATE:

Please make all checks payable to Michigan Transit Museum and mail to:
Dick Fountain -Membership Chairman
30814 Hennepin
Garden City, MI. 48135-1472

Donations are accepted and are tax deductible under 501(c)3. MTM is a non-profit organization.
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