Gift Membership Application

Friends of the South Carolina Archives and History Foundation

MEMBER INFORMATION:

q Mr. q Ms. q Mrs. q Dr. qOther_________________

Name: ___________________________________________________________

Name for additional card (family level and higher): ___________________________

Address: __________________________________________________________

City, State, Zip: _____________________________________________________

Phone: _________________________ Email: __________________________


GIVER INFORMATION

Name: _____________________________________________________________
Address: ____________________________________________________________
City, State, Zip: _______________________________________________________

Phone: _________________________ Email: __________________________

q Send renewal to me q Recipient

PAYMENT INFORMATION

Enclosed is my company’s matching gift form. 
Company name: ____________________________________________________

CATEGORY (please choose one)

q

$35 Individual Plus One

q

$60 Family

q

$100 Advocate

q

$250 Guardian

q

$500 Ambassador

Enclosed is my check for $_____ made payable to the SC Archives & History Foundation

Please charge $ ______ to my q Mastercard    q Visa  q American Express

Name on Card: _________________________________
Account Number: _______________________________
Expiration Date: ________________________________

Signature: _____________________________________

To send a gift, please print out this form and fill in the required information. Applications can be mailed to:

SC Archives & History Foundation
PO Box 1763
Columbia, SC 29202

Or fax this form to: (803) 252-0589

Gift membership packets are sent to the giver. Please allow 2-3 weeks for delivery.

Please allow 2-3 weeks delivery for your membership packet. For more information please call the membership office at (803) 251-0115 or Fax: 252-0589

Thank you for your generous support!