Chicagoland Historical Bus Museum

Membership Application

Name: _________________________________________

Address: _________________________________________

City, State, Zip: ___________________________________

Home Phone: ___________________________________

Membership Type: (circle one)

Associate Regular

Best time to contact: __________ am/pm

Membership Fee Enclosed: $____________

Additional Donation: $____________

Total Enclosed: $____________

Please tell us what you are interested in working on:

Please print and fill out this form, and mail to:

Chicagoland Historical Bus Museum

Attention: Memberships

P. O. Box 6203

Aurora, IL 60598-6203

(checks payable to Chicagoland Historical Bus Museum)