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MEMBERSHIP FORM, 2008-09

Name:_________________________

Organization:___________________________

Mailing Address:______________________________

City:_______________

State:______

Zip:___________

Phone:_________________

FAX:_________________

E-Mail:______________________________

Web Site:____________________________

_____ $25.00 - Organizations with paid staff.
_____ $ 5.00 - Volunteer organizations.

Tell Us About Your Organization
     No. of years in existence:_______
     No. of paid members:_______
     No. of staff:______
     No. of volunteers:________
     Do you have exhibit space?_________
     Do you have a newsletter?_________

Print a copy of this form, fill it out, and mail to:

Teresa Norman
Scott County Historical Society
235 South Fuller St.
Shakopee, MN 55379
Phone: 952-445-0378
E-mail: tnorman@scottcountyhistory.org