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: _______________________________________________________________
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Day Phone: ______________________ Evening Phone: ________________________
Email: _________________________________________________________________
Membership Level Desired: _______________________________________________
Payment Mode (Circle): Money Order Credit Check
Please make checks payable to: American Indian Genocide Museum