Join San Jacinto!
Your membership in the San Jacinto Museum will help promote and preserve the history of Texas.
Membership Application
___________________________________________________________________
Name
___________________________________________________________________
Address
___________________________________________________________________
City, State, Zip
___________________________________________________________________
Daytime Phone Evening Phone
___________________________________________________________________
E-mail
O I would like to receive e-mail about upcoming events.
O Gift. This membership is a gift from:
___________________________________________________________________
Name
___________________________________________________________________
Address
Membership Categories
Please check one of the membership categories below:
O San Jacinto Society $5000 O Independence Society $275
O Sam Houston Society $3000 O Freedom Society $150
O Chairman's Circle $2000 O Dual Lone Star Society $75
O Monument Society $1000 O Lone Star Society $50
O Museum Circle $500 O Student/Senior Citizen $25
Method of Payment
O My check is enclosed for $_____________________
O Charge $_____________________ to
O VISA O MasterCard O American Express O Discover
_____________________________________________ __________________
Card No. Expiration Date
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Signature
To charge your membership by phone, call: 281.479.2421
or mail to San Jacinto Museum of History, One Monument Circle, La Porte, Texas 77571-9585
