| Check One: |
Membership Type: |
Amount |
 |
Senior / Student |
$20.00 |
 |
Individual |
$25.00 |
 |
Family |
$30.00 |
 |
Supporting |
$100.00 |
 |
Lifetime |
$1,000.00 |
 |
Organization |
$100.00 |
 |
Professional/Business |
$125.00 |
 |
Corporate |
$250.00 |
 |
Additional Donation |
$ |
|
Total Enclosed |
$ |
| If your firm matches contributions,
please attach the signed company form. KHS is a 501(c)(3).
|
Checks to be made payable and mailed to:
Kirkland Heritage Society 203 Market Street,
Lower Level Kirkland, WA 98033 Resource
Center Phone: (425) 827-3446
Email: Help-line@kirklandheritage.com
Name____________________________________
Address__________________________________
City_____________________State____Zip_____ Home Phone _____________________________ Email_______________________________________
|