I want to become a member of the Blanden Art Museum:

Name
Address
City, State, Zip
E-mail
Level of Membership: Individual - $25-$39
Household - $40-$99
Business/Contributing - $100-$249
Patron - $250-$499
Benefactor - $500- $999
NEW Conservator - $1000 +
Additional Information: In the future I would like to receive information about the Blanden Memorial Art Museum on-line
  Please send me more information about your endowment Categories :permanent collection, educational services, & general operations.

Please send this form & your check made payable to:

BLANDEN CHARITABLE FOUNDATION P.O. Box 1254 Fort Dodge, IA 50501