Name:____________________________________________________
Address:__________________________________________________
City:_______________________ State:____ Zip:_________________
E-mail:__________________________ Phone:(_____)_____________
Membership Categories and Prices:
Student ◊ $23.00 Regular ◊ $45.00 Family ◊ $68.00
Sustaining ◊ $90.00 Contributing ◊ $180.00 Life ◊ $900.00
Nonprofit Redwood Empire Library or Historical Society ◊ $23.00
Your Membership Price $___________
Additional Donation to Reserve Special Funds:
The membership portion of the donation ($45/$900) is not deductible.
| Baggage Car # 605 Fund | $___________ |
| Coach Car # 29 Fund | $___________ |
| P&SR Boxcar #2 Fund | $___________ |
| P&SR Caboose #1 Fund | $___________ |
| Stindt Engine # 112 Fund | $___________ |
| Hogarty Library Fund | $___________ |
| Other Donation | $___________ |
(specify) ___________________________________________
For First Class mail, or International postage, add $10.00 $___________
TOTAL ENCLOSED $___________
Some questions so we can know more about our members and how to serve them better.
Do you have a NWP connection? Circle YES NO If so what? __________________________________________
Are you a modeler? Circle YES NO Railroad ______________________________ Scale _______
If you can volunteer, indicate with an 'x' your interest in these activities:
| Archives/Library/Museum | ___ | Car # 29/Baggage # 605 | ___ |
| Quarterly Programs | ___ | Awards Dinner Committee | ___ |
| Depot Restoration | ___ | Administrative Assistant | ___ |
| P&SR Caboose # 1 | ___ | Other _____________________ | ___ |
SOCIETY DUES POLICY: Dues are payable as of January 1 of each year. There is a 90-day grace period. Members who do not renew by March 31 of each year are dropped from our roster. New members joining after October 1 are considered paid in full for the next membership year. There is no grace period for first class mail privileges.
We sometimes make our membership list available to carefully screened organizations whose products and services may be of interest to you. If you prefer not to have your name made available, please put an X in this line: _____
Please print out this form and return it with your check or money order to: NWPRRHS, P. O. Box 667, Santa Rosa, CA 95402-0667
For office use only: Class :_____ FC:_____ Membership Number:________ Date:_________ Check # _______
Rev.3-4-17