Membership    

Send this page and your support to:

Niagara Area Historical Society
PO Box 114
Niagara, Wisconsin 54151-1100+
A non-profit organization.

Make Checks Payable to the:
Niagara Area Historical Society
Side Mark your check: "Home for the Grange"

Please Print:
Your
Name: _______________________________________ Maiden: _________________________

Address: _____________________________________________________________________

City: __________________________________ State: __________________Zip: ____________

Phone: ______________________________ E-mail: __________________________________

High School: ________________________________________________ Year: _____________

Given in  ___    honor  or   ___   memory of:
Indicate approx. what year to what year living in Niagara Area: _____________ to _______________

Name(s):    _________________________________________________________________________________________

Choose your level of support:                   ___ Friends of the Museum: $5.00 Plus

___ Silver Level:

$   20.00 Plus ___ "Better" Badger: $      500.00 Plus

___ Gold Level:

$   50.00 Plus ___ Executive Level: $   1,000.00 Plus

___ Platinum Level:

$ 100.00 Plus ___ CEO Level: $   5,000.00 Plus

___ "Best" of Niagara

$ 200.00 Plus ___ Corporate Level: $ 10,000.00 Plus

T h a n k Y o u ! ! !           2004-2005-2006 Home for the Grange

Niagara Area Historical Society  (c) 2006