Tejas Warrior

DALLAS HISTORICAL SOCIETY


Annual Contribution Level- Please check one.

Individual Memberships:

___ Historian ($50)   ___ Biographer ($100)

____ Collector ($250)    ____ Scholar ($500)   

____ Fellow ($1,500)     ____ Patron Fellow ($2,500)     ____Statesman ($5,000)

PLEASE PRINT

Mr./Dr./Mrs./Ms.:_________________________________ Spouse:____________________

Address:____________________________________________________________________

City:_______________________________ State:_________________ Zip:______________

Telephone #: Hm.___________________________ Cell_________________________

                     Wk.___________________________ FAX_________________________

Email:__________________________________________________

Payment: ____Check Enclosed    ____VISA/MASTERCARD    ____AMERICAN EXPRESS

Card #:____________________________________________ Exp. Date: _____/_____


Please mail to: DALLAS HISTORICAL SOCIETY, P.O. BOX 150038, DALLAS, TEXAS 75315-0038