Membership Application - cheshirechildrensmuseum's JimdoPage!

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Membership Application - please pick up your member card at museum.

Membership Type *see CCM Memberships for descriptions

$70.00

New or Renewal

New Membership

Renewal

Adult #1:

Name:

Adult #2:

Name:

Child #1:

Name:

DOB:

Child #2:

Name:

DOB

Child #3:

Name:

DOB:

Child #4:

Name:

DOB:

Additional Members:

Member Address:

City:

State:

Zip:

Phone:

E-mail:

Membership Application questions here:

Note: Please fill out the fields marked with an asterisk.