Cahoon Museum Membership Form

Fill out, print and send to: The Cahoon Museum Of American Art
                             P.O. Box 1853
                             Cotuit, MA  02635
                  or FAX to: (508) 420-3709

Name: 
Address: 
City:  State:  ZIP: 

Daytime Phone #:  Home Phone #: 

Please indicate category:

 Individual       $40           Family Dual  $60      
 Contributor      $100          Associate    $250       
 Sponsor          $500          Patron       $1,000
 Cahoon Society   $1,500        Benefactor   $5,000+

My company:  will match my contribution.

PAYMENT METHOD:
 Check (Payable to The Cahoon Museum) for $

 Please charge $ to my  VISA  MC  AMEX

Card Number  Exp Date: 

Signature: ______________________________________________________

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