Please join us! We invite you to support the preservation & advancement of working people's history by making a financial contribution to the American Labor Museum or by becoming a Museum member.

Name____________________________________________________________________________

Address_______________________________City______________State_______Zip____________

Union /Organization________________________________________________________________

Phone_________________________             Fax__________________________________

e-mail ________________________    

                (  )
In lieu of a membership, please accept my financial contribution
                                              in the amount of $________
_.

               (  ) Gift Membership. Please send an acknowledgment to\

               Name __________________________________________

              Address_________________________________________-

              Phone__________________________________________

              Email___________________________________________


                                                                                                                                       
Individual Membership                                            Union/Organization Membership
(  ) Senior/Student        $10.00                                   (  ) $50     x 3 years = $150       

(  ) General/Individual   $20.00                                   (  ) $100   x 3 years = $300               

(  )  Supporting/Couple $25.00                                    (  ) $200  x 3 years = $600

(  ) Sustaining/Family   $30.00                                    (  ) $500  x 3 years = $1,500

(  ) Benefactor             $50.00                                    (  ) $1,000 x 3 years = $3,000

                                                         (  ) Other - Please specify amount _________

                      Please make checks payable to: American Labor Museum and
                 send with this completed form to : Botto House National Landmark,
                            83 Norwood Street, Haledon, New Jersey 07508
                              Tel.: 973-595-7953          Fax: 973-595-7291
                                       e-mail: labormuseum@aol.com