GIFT MEMBERSHIP FORM

GIFT MEMBERSHIP FORM

GIFT MEMBERSHIP FORM

GIFT MEMBERSHIP

GIFT RECIPIENT

Please tell us more about who is receiving the gifted membership.

Name(s)(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone

GIFT GIVER

Please tell us about the gift giver.

Name(s)(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

SELECT A MEMBERSHIP LEVEL

With any level of membership you gift, the recipient will enjoy many benefits, including free site admission, a 10% merchandise discount, free admission to the archives as well as discounts on research services, invitations to special events, and a subscription to our quarterly newsletter The Crossing. Please specify the level of membership you wish to gift:

CHOOSE LEVEL(Required)

PAYMENT(Required)

My check is enclosed (Make payable to NCHS)

Cash (in person only)

Please debit my card

INSTRUCTIONS FOR DELIVERY

Mail to me for personal delivery

Mail directly to Gift Recipient

Credit card #

Expiration Date (mo/dy/year)

CVV code

Phone

This field is for validation purposes and should be left unchanged.

GIFT MEMBERSHIP

GIFT RECIPIENT

GIFT GIVER

SELECT A MEMBERSHIP LEVEL

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