Platte County Museum

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You are invited to become a member of the
Platte County Historical Society.

Tell us how to get in touch with you:
Name:
Address:
City:
State:		Zip:
Phone:		Fax:
E-mail:

	Individual	Family
Regular	$10.00/year	$15.00/year
Contributing	$15.00/year	$25.00/year
Friends of Museum	$50.00/year
Life Member	$100.00	$160.00
Supporting Member	$250.00
Patron of Museum	$500.00
Benefactor of Museum	$1,000.00 or more
Corporate-Life Member	$250.00

Complete form, before submitting, print and mail along with payment to:
Platte County Historical Society
P.O. Box 31
Columbus, NE 68601
By submitting this form, it will only allow the Historical Society the opportunity
to know of your interest in becoming a member.