Membership Application


To help support the Labor & Industry Museum's commitment to preserving the history of the labor and industry movement in Southwestern Illinois, print this form to send with your donation to the address below.

Please accept my donation at the level indicated.

___Trustee - $1,000 or greater
Benefits include a subscription to the Labor & Industry Museum Newsletter, invitations to special and permanent exhibition opening receptions and a presentation plaque.*

___Sponsor - $500
Benefits include a subscription to the Labor & Industry Museum Newsletter and invitations to special and permanent exhibition opening receptions.*

___Family - $100
Benefits include a subscription to the Labor & Industry Museum Newsletter and invitations to family events.*

___Individual - $30
Benefits include a subscription to the Labor & Industry Museum Newsletter.*

___Other
Please accept my tax-deductible contribution in the amount of $______

*Benefits are good for one year.

All contributions are tax-deductible to the extent permitted by law. Please make checks payable to the Labor & Industry Museum.
Mail check and this completed form to:

Labor & Industry Museum
P.O. Box 8242
Belleville, Illinois 62222-8242

Name:_____________________________________________________
Street Address:____________________________________________
City:_______________________ State:___________ Zip:___________
Telephone:_________________________________________________
Email:______________________________________________________