Gift membership Payment Form | Metlar Bodine House Museum

Gift membership Payment Form

Membership Category *

$ 15.00 Student/Sr. Citizen

$ 30.00 Individual

$ 50.00 Family

$ 75.00 Supporting

$ 100.00 Organization

$ 125.00 Sponsor

$ 250.00 Benefactor

$ 750.00 Patron (individual)

$ 2,500.00 Corporation

Total Amount

Email Address: *

Gift Membership For

First Name *

Last Name *

Organization Name

(if applicable)

Street Address *

City *

State *

Postal Code *

Country

Please fill in the information below so that the gift recipient named above will receive an acknowledgement of your generosity.
This membership is a gift from:

First Name *

Last Name *

Organization Name

(if applicable)

Street Address *

City *

State *

Zip/Postal code *

Country *

Home/Cell Phone

Your personal message to gift recipient

The Fellowship for Metlar House is a 501C (3) tax exempt foundation, Federal EIN 52-187-497.
Please be advised that no goods or services are provided in return for your contribution. Your donation is generally deductible for tax purposes.