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Membership & Donation Form
Full Name *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Type of Donation *

Individual $25-$44 Family $45-$74 Contributor $75-$249 Fans of Lighthouse Hill $250-$499 Monhegan Art Enthusiasts $500-$999 Friends of the Collection $1,000-$2,499 Curator's Circle $2,500-$4,999 Director's Circle $5,000 or more

Donation Amount *

USD Description

Credit Card

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