Survey

Please fill out the following Survey so we can get an idea about LEVEL OF INTEREST in developing this Model Railroad Museum.

Membership Form

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

E-Mail Address*

Web Site URL

Street Address*

City*

State/Prov*

Zip/Postal Code*

Country*

Home Phone*

Business Phone

Fax

I wish to become a member NOW for a tax-deductible donation of $25/mo.
This will expedite the ability to acquire a facility.
(Don 't forget to click on the Donate button at the bottom of this page, after submitting this form.)

	Yes
	No

I wish to become a member and donate:

	$25 per month (Free admission of one person for as long as your monthly donation continues)
	$50 per month (Free admission for you and your family for as long as your monthly donation continues)

I PLEDGE to become a member for $25/mo as soon as a facility is secured for the Museum: