Membership Application Form

MEMBERSHIP FORM

Thank you for your interest in becoming a member of the Independence Historical Museum & Art Center! Please fill out the following form and make your payment at the end. We look forward to your involvement in the museum, whether you are interested in taking art classes, volunteering for a specific committee, training to become a docent, or simply enjoying the many events we have to offer! As a member you will receive free museum admission, a discount off classes, etc., periodic newsletters and other communications from us, invitations to special events and opportunities, invitations to our monthly Member's Luncheon (Sept. through May), and much more. Welcome!
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Committees I would be interested in helping with at the museum:
MEMBERSHIP LEVELS
If you are choosing a Couple or Family membership, please add the names of your other members.

MEMBERSHIP FORM