Siuslaw Pioneer Museum

__ Individual                   $15.00
__ Family                        $20.00
__ Organization              $25.00
__ Businesss                   $30.00
__ Supporting Business  $50.00
     (with business card display)
__ Friend                          $50.00
__ Supporting                 $100.00
__ Patron                        $150.00
__ Lifetime                  $1,000.00

__ Renewal    __ New Member    __ Memorial
Membership year is January 1 through December 31

  In memorial giving, please give the name of the memorialized, the donor's name and address and the names and addresses of persons to whom acknowledgement is to be sent.
  Lifetime donations will have their name(s) or a name of their choice, added to a plaque in Siuslaw Pioneer Museum, an excellent way to honor one's family while investing in the Museum's future.
  Endowments are handled through "Western Lane Foundation" phone (541) 997-1274

Make checks payable to: Siuslaw Pioneer Museum Association and mail to:

Siuslaw Pioneer Museum Association
PO Box 2637
Florence, OR 97439