Membership Form

Please complete and return payment to:        Brevard Station Museum

                                                                             112 South Main Street

                                                                             Stanley, NC   28164

I would like to become a member or renew my membership at the following

Level:                                                    

o   Annual Member             $25                                                 

o   Friends                             $50    

o   Donors                             $75                                

o   Patrons                           $125                                     

o   Benefactors                   $500                                    

o   Magnolia Circle           $1000                               

I am not interested in membership at this time

but have enclosed a donation of $____________.        

Name: _________________________________

Address: ________________________________

City: ___________________________________     

 State: ___________________ Zip: ___________ 

 Phone: _________________________________    

E-Mail: _________________________________                                                    

Make checks payable to Brevard Station Museum.

 Thank you for your support of Brevard Station Museum