QUINCY QUARRY and GRANITE WORKERS MUSEUM
MEMBERSHIP APPLICATION


Name:  ________________________________________________________________

Address:  ______________________________________________________________

City:  _______________________  State:  _________________  Zip:  _____________

Phone:  _____________________________  E-mail:  __________________________

*you can join at any time during the year. 
*The membership year starts on Jan.1st and ends on Dec. 31st. 
*If you sign up on Sept. 1st or later, there is a grace period so that you will be
 considered paid through the following year.


	Annual Membership Dues
(    )  Student		$5			(    )  Friend		$50
(    )  Single		$15			(    )  Patron		$75
(    )  Family		$25			(    )  Business	$100


Please make check payable to QUINCY QUARRY and GRANITE WORKERS MUSEUM and 
mail to Quincy Quarry and Granite Workers Museum, P.O. Box 690724, Quincy, MA 02269