Membership Form

If you prefer to mail in your Membership dues, please print out the following form and send to the address below. Or call the Membership office to charge your Membership over the phone: 781/259-3629.

Name:	___________________________________
Address:	___________________________________
City/State/Zip:	___________________________________
Day Phone:	___________________________________
Evening Phone:	___________________________________
Email Address:	___________________________________
Names of your children under the age of 21:	___________________________________
	___________________________________
	___________________________________
	___________________________________
	___________________________________
Membership Level (check one):	____ $60 Individual ____ $90 Household ____ $150 Friend ____ $300 Sponsor ____ $600 Patron ____ $1000 Julian Club ____ $50 Individual Teacher ____ $80 Household Teacher ____ $150 School ____ $150 Library
Total enclosed	$ __________ . ____
	Please make the check payable to: DeCordova Museum
Charge:	Mastercard ____ Visa ____
Card	# __________________________________
Expiration Date	____ / ____
Signature	___________________________________

You can also support DeCordova through your company's matching gift program. Contact your company's personnel department for a matching gift form.

Print out the form above and send it to:

DeCordova Museum and Sculpture Park
Membership Department
51 Sandy Pond Road
Lincoln, MA 01773

Or charge your Membership by phoning 781/259-3629.