Oregon Electric Railway
Historical Society

a non-profit Oregon Corporation
3995 Brooklake Road
Brooks, OR 97303

Membership Application
Please add my name to the membership roster,
My annual dues are enclosed

Date:

New Member

Renewal

Choose Your Membership Level

Active $30

Sustaining $250

Family $40

Life $500

Contributing $50

Benefactor $1000

Supporting $100

Donation: Amt.___

If donating, please specify purpose:

Name

Age

Address

City

State

Zip

Phone

E-mail

Occupation

Gift Membership:

(If you are giving this membership as a gift, please, enter YOUR name).

Please indicate your interests:

Advertising & PR

Gift Shop & Ticket Sales

Archives

Landscaping

Car Restoration

Tour Guide

Displays

Track Maintenance

Electrical

Trolley car operation

Equipment Maintenance

Other: ______________

Note: Membership is on a calendar year basis

Signature:

Your signature states that you accept the OERHS Mission Statement (on reverse of application) and will abide to the bylaws of the Corporation.

Office use: Dep. ________ Enter:_______ Card issue: ________