Membership Application Form

Prorated Dues Schedule

NOTE:  The membership year runs from January 1st through December 31st.  Those individuals, institutions or businesses joining after July 1st should use this form and the prorated fee structure noted below.

Instructions: Print out this page, complete it and mail, along with check to Michigan Museums Association.

Prorated Fees for those joining after July 1st (check one)
	Individual
	Student	$12
	Staff of Member Organization	$15
	Individual	$18.50
	Contributing	$30
	Sustaining	$60
	Patron	$300
	Institution (fees based on budget)
	$0 - $25,000	$15
	$25,001 - $100,000	$30
	$100,001 - $250,000	$45
	$250,001 - $500,000	$60
	$500,001 - $1 Million	$120
	$1 Million - $2.5 Million	$180
	$2.5 Million - up	$240
	Business
	Contributor	$60
	Associate	$300
	Sponsor	$600

Member Name _________________________________________

Institutuion Name ______________________________________

Address _____________________________________________

City/State/Zip _________________________________________

Phone/Fax ___________________________________________

Email/Web ___________________________________________


Amount Enclosed $____________________


MAKE CHECKS PAYABLE TO:
Michigan Museums Association

RETURN TO:
MMA Membership
PO Box 10067
Lansing, MI 48901-0067