Yes, I want to help make Rugby history! Make me a member (or renew my membership) as indicated:
| _____ New Member _____Returning Member |
|
|
|
|
|
_____
|
Individual. $25 |
|
_____
|
Family or Sustaining. $40 |
|
_____
|
Rugby Supporter. $65 |
|
_____
|
Rugby Patron. $100 |
|
_____
|
Rugby Colonist. $250 |
|
_____
|
Rugby Benefactor. $500 |
|
_____
|
RUGBEIAN. $1,000 |
| Name: | ______________________________ |
| Address: | ______________________________ |
| City, State, Zip: | ______________________________ |
| Phone: | ______________________________ |
|
If
paying by credit card please provide the information below:
|
|
| CC Number: | ______________________________ |
| Expiration Date: | _______________ |
| Name on Card: | ______________________________ |
If mailing the form with payment
please send to:
Historic Rugby
Attn: Memberships
PO Box 8
Rugby, TN 37733
or use a credit card and fax to (423)628-2266
Thank
you for your support and welcome to the Rugby family!