Yes! I would like to become a supporting member of the Norwegian-American Historical Association.

Membership levels (choose one):

Please include an additional $15 for postage costs to Canada and any country outside the U.S.

___ ASSOCIATE - $55
___ SUSTAINING - $125 (Includes a tax deductible gift of $70)
___ PATRON - $250 (Includes a tax deductible gift of $185
___ 5-YEAR SUSTAINING - $550 (Includes a tax deductible gift of $275)
___ 10-YEAR SUSTAINING - $1000 (Includes a tax deductible gift of $450)
___ STUDENT - $40 (Full-time undergraduate and graduate students pursuing a degree)

___ ADDITIONAL DONATION: _________

Enclosed is my check or money order for $__________.

Name: ________________________________________________________

Occupation: ___________________________________________________

Address: ______________________________________________________

______________________________________________________________

______________________________________________________________

Birthdate: _____________________________________________________

E-mail: ________________________________________________________

Telephone: ____________________________________________________

Please describe your interest in NAHA

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Return completed membership form to:

Kim Holland
NAHA Administrative Director
1510 St. Olaf Avenue
Northfield, MN 55057-1097