Please print out this page and send it to:  American Indian Genocide Museum
                                                               11013 Fuqua, PMB#178
                                                               Houston, TX 77089-2510
American Indian Genocide Museum
Membership Form

Benefactor Membership                                Patron Membership
$1000+                                                               $500-$1000
Special invitations to all events                          Special invitations to all events                
Calendar                                                            Calendar
Honorable Mention                                             Honorable Mention
American Holocaust Book                                  American Holocaust Book        
Golf Shirt                                                            Golf Shirt
Annual dinner party and private exhibit              Annual dinner party and private exhibit
Special Gift - Native made Tomahawk

Sponsor Membership                                  Donor Membership
$200 - $500                                                    $100
Special invitations to all events                       Special invitations to all events
Calendar                                                         Calendar
Honorable Mention                                          Honorable Mention
Cup & T-Shirt

Family Membership                                     Individual Membership
$50                                                                $25
Special invitations to all events                      Special invitations to all events
Calendar                                                        Calendar

Student Membership
$15
Special invitations to all events        
    

Full Name: _____________________________________________________________
Address: _______________________________________________________________
            _______________________________________________________________

Day Phone: ______________________  Evening Phone: ________________________
Email: _________________________________________________________________
Membership Level Desired: _______________________________________________

Payment Mode (Circle):   Money Order         Credit                Check                


Please make checks payable to:
American Indian Genocide Museum