<%@LANGUAGE="JAVASCRIPT" CODEPAGE="1252"%> Norwood Park Historical Society

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Become a member of the Norwood Park Historical Society. Member benefits include:

Instructions: Print out the form below and fill it in. Mail your check to the Norwood Park Historical Society, 5624 N. Newark Ave., Chicago, Ill. 60631

2009 membership levels:

( ) Individual ($20)

( ) Family/dual ($25)

( ) Life ($350)

( ) Business ($70)

2009 membership ends Dec. 31, 2009.


Donor levels:

( ) Benefactor ($25,000 or more)

( ) Patron ($5,000 to $24,999)

( ) Sponsor ($1,000 to $4,999)

( ) Donor ($ 500 to $999)

( ) Contributor ($ 300 to $499)

( ) Associate ($ 100 to $299)

NAME(S)_________________________________________________

ADDRESS________________________________________________

CITY/STATE/ZIP______________________________________________

E-MAIL ADDRESS_________________________________________________

PHONE_________________________________________________

AMOUNT_________________________________________________

I would like my contribution to memorialize (deceased person): __________________________________________

I would like my contribution to honor (living person): _________________________________________________

Contribution categories are cumulative. Contributions are tax-deductible as allowed by law.

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