Membership Form

Please fill out this form, and mail to the society.

I/we would like to be a Friend of
The Country Grain Elevator Historical Society
155 Prospector Trail
Bozeman, Montana 59718-7988


Enclosed are annual dues (in US funds) of:

$20 individual/family ($25 outside US)
$100 business

We accept checks, cash, or PayPal to:
countrygrainelevatorhs(at)gmail.com

 

I would like to make a tax-deductible donation of:

Other
$101-$249 (Boot)
$250-$499 (Leg)
$500-$999 (Distributor)
$1000+ (Cupola)

Name Last, First (required)

 

Mailing Address

City
State
Zip
Country

Phone

FAX

Email address   (required)

 

Please send a gift membership to:

Name Last, First

Mailing Address

City
State
Zip
Country

Phone

FAX

Email address

Questions or Comments?

Please review this form for accuracy before you submit

For more information write:

The Country Grain Elevator Historical Society
155 Prospector Trail
Bozeman, MT 59718-7988

call or text
406.581.4397
406.581.1076
or email
bselyem@country-grain-elevator-historical-society.org
(include your name, address & phone number)



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