NCMC membership form - new or renewal

Please complete this form to join the NCMC or renew a membership. [ ] NEW [ ] RENEWAL

NAME_______________________________ TITLE___________________________________

INSTITUTION_________________________________________________________________

MAILING  ADDRESS___________________________________________________________

_________________________________________ZIP CODE_______________-____________

PHONE (            )__________________________ FAX (            )_________________________

E-Mail________________________________________________________________________

The NC Museums Council communicates news items and announcements (on average, once a week) and provides notice of its quarterly newsletter being posted on the website via e-mail. Please confirm that you approve receiving e-mail at the above address for that purpose. If you do NOT check this item, we will assume that, if you are interested, you will check the www.ncmuseums.org website and our ncmuseums.blogspot.com blog periodically to obtain these news announcements.

[ ] Yes, you may add my e-mail address to the Council's newsannouncement e-mail list.

ANNUAL DUES - INSTITUTIONAL MEMBERS      ______Annual Budget:   $0 to $50,000                                        $ 50.00      ______Annual Budget:   $50,001 to $100,000                             $ 75.00      ______Annual Budget:   $100,001 to $250,000                           $100.00      ______Annual Budget:   $250,001 to $500,000                           $150.00      ______Annual Budget:   $500,001 to $1,000,000                        $200.00      ______Annual Budget:   Over $1,000,000                                   $250.00      ______Corporate (1):    $100.00 (the member company may send 1 representative to attend the annual meeting at the NCMC member registration fee)      ______ Corporate (2): $250.00 (the member company may send 2 representatives to attend the annual meeting at the NCMC member registration fee) INDIVIDUAL MEMBERS      ______$20.00 per membership      ______ Student: $5.00 (please include a copy of a dated proof of enrollment, such as a class schedule or tuition receipt)

SECTION MEMBERSHIP: One section membership is included free with each membership. Please indicate which section. Additional section membership(s) may be obtained for $2.00 additional dues, per section. Please check all sections you wish to have included with your membership.

______ART          ______HISTORY          ______SCIENCE         ______CHILDREN              
..............
Please make check to NCMC and send to: NCMC Treasurer, PO Box 2603, Raleigh, NC 27602. If you have questions, please contact Julie Bledsoe-Thomas, NCMC Treasurer, by e-mailing treasurer@ncmuseums.org.