The Northwestern Pacific Railroad Historical Society
                        Membership Application form

Name:

Address:

City:                                                     State:                Zip:

Phone:                                                  E-mail:

Membership Categories and Prices:

Student - $15.00                      Regular - $30.00                      Family - $45.00

Sustaining - $60.00                   Contributing - $120.00 Life - $600.00

Nonprofit Redwood Empire Library or Historical Society....... $18.00

 

Your Membership Price                                                                                    $___________

Additional Donation to Reserve Special Funds:

Current Restoration Project Fund                                  $___________

Stindt Engine 112 Fund                                     $___________

Hogarty Library Fund                                                   $___________

Santa Rosa Depot Display Fund                                   $___________

Healdsburg Depot Restoration Fund                             $___________

Hopland Depot Restoration Fund                                  $___________

Other Donation (specify) ___________________        $___________

For First Class mail, or International postage, add $10.00                                 $___________

TOTAL ENCLOSED                                                                                      $___________

 

Some questions so we can know more about our members and how to serve them better.

 

Do you have a NWP connection? Circle YES NO    If so what? ___ญญญญญญ__________________________

Are you a modeler? Circle YES NO   Railroad ______________________________ Scale _______

If you can volunteer, indicate with an 'x' your interest in these activities:

Archives/Library/Museum                 ___          Current Restoration Project     ___

Quarterly Programs                            ___        Awards Dinner Committee     ___

Depot Restoration                               ___       Administrative Assistant         ___

NWP 100th Birthday committee         ___         Other (specify) _______________________


SOCIETY DUES POLICY: Dues are payable as of January 1 of each year. There is a 90-day grace period. Members who do not renew by March 31 of each year are dropped from our roster. New members joining after October 1 are considered paid in full for the next membership year. There is no grace period for first class mail privileges.

 

We sometimes make our membership list available to carefully screened organizations whose products and services may be of interest to you. If you prefer not to have your name made available, please put an X in this line: _____


Please print out this form and return it with your check or money order to:

NWPRRHS, P. O. Box 667, Santa Rosa, CA 95402-0667

  

For office use only:

Class:

FC:

Membership Number:

Date:

Check #