The Beth Naylor Museum

Membership Form

Please Print this form using the print button on your browser and
mail your membership to:
The Beth Naylor Museum
Box 910
Russell, MB, R0J 1W0

(__) YES! I would like to be a member of the Beth Naylor Museum
Please sign me up under the indicated category:
  • $10.00 - Individual
  • $25.00 - Family
  • $100.00 - Corporate
(__) YES! I would like to make a donation towards the Beth Naylor Museum.
  • $10.00
  • $25.00
  • $50.00
  • $100.00
  • Other:____________
(__) YES! I would like to become a volunteer for the Beth Naylor Museum.
   
Name/
Organization:		 ____________________________________________________
Address: ____________________________________________________
Telephone: ____________________________________________________
Fax: ____________________________________________________
Email: ____________________________________________________
Contact Person: ____________________________________________________
Contact Phone: ____________________________________________________

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