Membership Request Form

Please complete the membership form below for our staff to review or, if you prefer, you may download a printable version here.

Your membership will be processed as soon as we recieve your payment. Membership is for the calendar year, January 1 through December 31.

1. Select level of membership

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After completion of this form, payment should be mailed to:
Lane County Historical Society
P.O. Box 5407
Eugene, OR 97405-3819
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Payment required for selected membership is $0
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Please select a membership type here-----------------Individual Adult ($25)Individual Senior ($15)Institutional ($25)Family [2 adults, grandparents, and children under 17] ($50)-----------------Century Society ($100)Cal Young Society ($250+)Corporate ($250+)Lifetime ($1250+)

New LIFE members may designate below the use to which their money is to be put -OR- additional contributions may be made for general or restricted purposes. Check any Fund(s) below.

Harris Fund. Used for the upkeep of the Eugene Masonic Cemetery, but can be used for other purposes as well.
Cemetery Fund. Restricted to the upkeep of the Eugene Masonic Cemetery.
Museum Fund. Restricted to the support of the Lane County Historical Museum.
Barrette Book Fund. Restricted to the purchase of library materials, supplies, and equipment for the Lane County Historical Museum.
Calder Fund. Restricted to the publication of monographs related to the history of Lane County.
General Fund. Used for general operating expenses and The Artifact newsletter.
« Check All

2. Enter your contact information
This information is for administrative purposes only. All information collected below is confidential and will not be used for anything but contacting you in regards to your request.

Email

First Name

Last Name

Company/School

Street

City

State

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code

Phone

3. Additional information
Enter any additional information that may help us assist you.

4. Confirm your information
Please make sure all the information you are submitting is correct. When you are satisfied with the information, click 'next' to submit your request. Missing and/or incorrect information in the form will result in delayed processing. Please check form carefully.

 

Note: Fields marked (*) are required.