Membership Form
Print this page, fill in the
form and mail to:
Membership Department
The Children's Museum of Memphis
2525 Central Avenue
Memphis, TN 38104-5926
Or fax to:
901-458-4033
To join or renew your membership using a
credit card:
Online Membership Form
_____ Basic (2
people) $60
_____ Family I (4 people) $80
_____ Family II (6 people) $95 [Add $10 for each additional person]*
_____ Supporter $150
_____ Sponsor $300
_____ Benefactor $500
_____ Patron $1,000
_____ Add Nanny or Babysitter $15 extra
_____ *I want to add _____ people to my Family II Membership for $10 per
person
_____ New Membership _____ Gift Membership
_____ Renewal (provide
current membership number: ____________________)
Date: ____________________
Salutation (circle one): Mr.
Mrs. Dr. Drs. Miss Ms.
Mr. & Mrs.
Membership Name:
____________________
Spouse's Name: ____________________
Address: ____________________
City: ____________________
State: _____ Zip: __________
Home Phone: ____________________
Business Phone: ____________________
Email: ____________________
Optional Nanny or
Babysitter Name ($15
extra): ____________________
If Applicable:
Salutation (circle one): Mr.
Mrs. Dr. Drs. Miss Ms.
Mr. & Mrs.
Gift From (name): ____________________
Address: ____________________
City: ____________________
State: _____ Zip: __________
Home Phone: ____________________
Email: ____________________
Send gift certificate to:
____________________ OR Send initial membership
packet to: ____________________
Send annual renewal
notice to: ____________________
_____ Payment Enclosed: Make checks payable to The Children's Museum of Memphis
_____ Charge to: _____ VISA
_____ MasterCard _____ Discover
Account Number:
____________________
Expiration Date:
____________________
Signature: ____________________
For membership
information:
Email Membership & Development Manager or call 901-320-3171
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