The Northwestern Pacific Railroad Historical Society

A non-profit 501(c)(3)organization

Membership Application form



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 # _______


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