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Membership Form
Name:_________________________________________________________
Address:________________________________________________________
_______________________________________________________________
_______________________________________________________________
City:___________________________________________________________
State:____________________ ZipCode:______________________________
Phone: (______)__________-____________________
Membership Dues: (Please Check One)
| Senior Citizen or Student | $7.00 | |
| Individual | $12.00 | |
| Household | $18.00 | |
| Corporate | $50.00 | |
| Contributing | $100.00 | |
| Sustaining | $150.00 | |
| Patron | $250.00 + |
Friends of the Sibley Historical Site ©2000
Please make your checks payable to: Friends of the Sibley Historic Site
Please Mail your Check and this Form to:
P.O. Box 50772
1357 Sibley Memorial Highway
Mendota, MN 55150