Printable Membership Form

Please check one: New  Renew  
Individual Membership $15.00
Institutional Membership $30.00		 $
Additional Contribution $
Total Enclosed $

Name:
Position:
Museum:
Address:

City:
State:
Zip:
Phone:
Fax:
E-Mail:
Web Site:

Print the membership form and return with payment to:

Tom Lynch
Boys Town Hall of History
14057 Flanagan Blvd.
Boys Town, NE 68010
phone 402-498-1185
fax 402-498-1159
email lyncht@boystown.org

Check payable to NMA. Benefits extend during the calendar year. Please allow 4 weeks for processing.

 Thank you for your support!

Questions or comments about NMA, contact a board member in your area.
September 10, 2004