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 Corporate $3000 O Freedom Society $120
O Sam Houston Society $3000 O Dual Lone Star Society $60
O Monument Society $1000 O Lone Star Society $40
O Independence Society $500 O Student/Senior Citizen $20
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
______________________________________________________________
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