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2. First Name*
3. Last Name*
5. Address
7. City
8. State
9. Zip Code
11. Home Number
13. Cell Number
15. Membership Categories and Dues, Paid Annually in January, Except Lifetime Membership

    1. Business/Professional ($25)
    2. Contributing ($15)
    3. Family ($10)
    4. Individual ($5)
    5. Junior Historian (student) ($3)
    6. Lifetime ($150)
    7. Sustaining ($50)
17. Voluntary Donation
19. Method of Payment
    Checks Payable to: Brown Deer Historical Society Mail to: Treasurer, Brown Deer Historical Society 4800 W Green Brook Drive Brown Deer, WI 53223
21. Post Custom Field
23. 
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25. 1. Receive an email copy of this form.
26. Email address

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27. Submit

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