Friends of Willard House
Online Membership Form

Please select the desired membership category and payment method, and complete the contact information.

	None, I have a question about membership (see below).
	Robinson Society (Life Membership)	$10,000
	Simon Willard Society	$5,000
	Aaron Willard Society	$1,000
	Benjamin Willard Society	$500
	Ephraim Willard Society	$250
	Journeyman	$100
	Apprentice	$55
	Family	$40
	Individual	$25
	Corporate Sponsor - Please send information	$100 +

[Please add $5 for international memberships.]

Payment Method

I will contact you by phone (508-839-3500) with my credit card
information (Discover, MasterCard and Visa accepted).

I will send my payment to the museum
(11 Willard Street, North Grafton, MA 01536-2011). *

Please enter here any membership questions.

Please tell us how to contact you.
( * **Name, Address and E-Mail Address are required)**
* Name
* Address

City	State	ZIP
Country
Phone
FAX
* E-mail

* You do not need to print out this form and send it with your payment as your application will be e-mailed to the museum. However, please provide your name and address when sending payment.

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The right to download and store or output the articles and pictures in this web site is granted to users for their personal use only. Any other reproduction, by any means - mechanical or electronic - without the express written permission of the Willard House and Clock Museum is strictly prohibited.

Send comments on this web site to webmaster@willardhouse.org

This web site maintained by Ron Price.

Friends of Willard House Online Membership Form

Friends of Willard House
Online Membership Form