...of the Charles Perdew Museum Association

and be part of an

“Illinois River Tradition.”

If paying by check, Visa or Mastercard:

 Print this page, complete the form and send it with your payment to:

Charles Perdew Museum Association
PO Box 103
Henry, IL  61537

If paying online with Visa or MasterCard:

Go to the Contact Us page on our website and indicate you are interested in becoming a member, next, in the comments section note what type of membership (Individual, Family or Corporate/Business) and then complete the remainder of the form, or call us at 309-364-3279.
(The Paint Store)

Name: ______________________________________________________________

 Address: ____________________________________________________________

 City: _____________________________State: ___________ Zip: ______________

 Phone: ___________________________ Email: ____________________________

 Membership Type:

£ Individual $25          £ Family $40          £ Corporate/Business $75

 Additional Donation: $____________   Total Amount Enclosed: $______________

 Credit Card Number:  _____________________________  Expires:  ____________

        Charles Perdew Museum Association
                    914 Front Street
                    P.O. Box 103
             Henry, Illinois 61537-0103