Please print out the EASY PRINT application form and fill it out completely.
Mail it to the Keeler Tavern Museum at the address shown below or Fax it to 203.438.9953.

Please indicate type of membership and enclose the appropriate amount.

___ Individual-- $25
___ Family-- $50
___ Contributing -- $100
___ Patron/Business-- $250
___ Life -- $1000

___I would like to give
a gift membership.

___ Individual-- $25
___ Family-- $50
___ Contributing -- $100
___ Patron/Business-- $250
___ Life -- $1000

Memberships are renewable
July 1 of each year.
Make checks payable to:
Keeler Tavern Museum
And send them to:
Keeler Tavern Museum
P.O. Box 204
Ridgefield, Connecticut 06877
___Renewal     ___New Membership ___Gift (address if different)
Name Name
Address

Address
City/State
City/State
Zip
Zip
Phone Phone
e-mail e-mail
___Check/Money Order Enclosed in the amount of _____________     l    ___ MasterCard or Visa
Card Number:
Expiration Date:

Signature:

 
FOR EASY PRINT APPLICATION FORM CLICK HERE

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