Shaw Historical Library Association Membership

_________________________________________________________________________________
Signature
 

_________________________________________________________________________________
Name (please print)
 

_________________________________________________________________________________
Street
 

_________________________________________________________________________________
City/ State                                                                                            Zip Code
 

Choose from the following:

____New Membership ____Renewed Membership ____Gift Membership

Membership Structuture (choose category of membership):

____Individual Membership ($25.00) - One year membership includes receipt of the Shaw Historical Library Newsletter, the lastest issue of The Journal of the Shaw Historical Library, and invitation to all library events.

____Student Membership ($15.00) - Same as an individual membership. Requires proof of student status (example: copy of student ID card)

____Continuting Membership ($50.00 to $199.00) - One year membership includes the same benefits as an individual membership plus a certificate of recognition.

____Sustaining Membership ($200.00 +) - One year membership includes the same benefits as a continuing membership plus special recognition from the Shaw Historical Library.

Please print and complete the above form and mail, with payment, to: The Shaw Historical Library
Oregon Institute of Technology
3201 Campus Dr.
Klamath Falls, OR  97601