Membership Application

__Student (Full Time)   $10     __Individual   $50     __Family/Associate  $75     __Discoverer   $100

 __Heritage   $250      __Ace of Clubs   $500      __Whitaker   $1000      __Draughon   $5000

__New Membership      __Renewal

Please Print

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Last Name                                                                First Name(s)

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Company/Organization

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Address

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City                                    State                        Zip

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Home Phone                                            Business Phone

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Email Address

Please make check payable to: Texarkana Museums System
P.O. Box 2343, Texarkana, TX-AR 75504-2343

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