membership form - LBJ Presidential Library

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Membership Enrollment
(Printable Form)
To become a member of the Friends of the LBJ Library, please choose a membership level below:
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General membership
General membership for two
Senior citizen membership (65 and over)
Senior citizen membership for two
Sustaining membership
$80
$160
$65
$130
$250
Title: Dr./Mr./Mrs./Ms. (please circle) Other: _________________
Name: ________________________________________________
Address: ______________________________________________
City: ______________________ State: _____ Zip: ____________
Telephone: ____________________________________________
Email address: __________________________________________
If you provide an email address you will receive our monthly eNewsletter.
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Enclosed is my check. Please make check payable to the
Friends of the LBJ Library.
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Please charge my credit card.
Type of card: VISA ____ MasterCard ____ AMEX ____
Card Number: ______________________________________________
Expiration Date: ____________________________________________
Name on card: ______________________________________________
Signature: _________________________________________________
Please send a gift membership to:
Title: Dr./Mr./Mrs./Ms. (please circle) Other: ____________
Name: ____________________________________________________
Address: __________________________________________________
City, State, Zip _____________________________________________
Telephone: ____________________________________________
Email address: __________________________________________
Thank you for your support. Please mail this form to:
Friends of the LBJ Library
2313 Red River Street
Austin, Texas 78705
Or, you may fax to (512) 232-2285. Questions may be directed to (512) 721-0176.
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