Membership Application Form

Membership Level

                                                  
Individual $10.00
Family $15.00
Sustaining $25.00
Pioneer $50.00
Century $100.00
                                     

Name________________________

Address______________________
_____________________________
_____________________________

Email_________________________

Phone________________________

If Family Membership or higher level, please list the names of other family in your household:



*Please complete and return with your check or money order to:
Marcus Historical Society
208 W Cedar Street
PO BOX 321
Marcus, IA 51035